Provider Demographics
NPI:1861877458
Name:VINSON, NICHOLE (MSW)
Entity type:Individual
Prefix:MRS
First Name:NICHOLE
Middle Name:
Last Name:VINSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CRABAPPLE LANE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823
Mailing Address - Country:US
Mailing Address - Phone:908-800-2170
Mailing Address - Fax:
Practice Address - Street 1:12 CRABAPPLE LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:NJ
Practice Address - Zip Code:08823-1406
Practice Address - Country:US
Practice Address - Phone:908-800-2170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor