Provider Demographics
NPI:1861725301
Name:VERHINES, NICHOLLE MARIE (MA LPC)
Entity type:Individual
Prefix:
First Name:NICHOLLE
Middle Name:MARIE
Last Name:VERHINES
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 S.E. 25TH STREET
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73129
Mailing Address - Country:US
Mailing Address - Phone:405-636-1463
Mailing Address - Fax:405-635-8417
Practice Address - Street 1:744 S.E. 25TH STREET
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73129
Practice Address - Country:US
Practice Address - Phone:405-636-1463
Practice Address - Fax:405-635-8417
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4524101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health