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Individual
NICOLE R WILDROUDT
Active
Individual
NICOLE R WILDROUDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
86000458A
IN
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.162012
OH
101YP2500X
Professional Counselor
E.2606445
OH
101YP2500X
Professional Counselor
Primary
LPC-24135
AZ
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/20/2015
Last updated
07/29/2026
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