# NICOLE RUDD, LCPC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053906685
- **Authorized official:** NICOLE RUDD LCPC (OWNER)
- **Authorized official phone:** (202) 406-0929

## Contact information

- **Practice address:** 2905 MITCHELLVILLE RD STE 112, BOWIE, MD 20716-1321
- **Practice address phone:** (202) 406-0929
- **Mailing address:** 2905 MITCHELLVILLE RD STE 112, BOWIE, MD 20716-1321
- **Mailing address phone:** (202) 406-0929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 03/05/2021
- **Last updated:** 03/05/2021