Individual
JACQUELINE PATRICIA NICCOLAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7919 48TH AVE STE 200, KENOSHA, WI 53142-2023
(414) 622-0157
Mailing address
7919 48TH AVE, KENOSHA, WI 53142-2023
(602) 565-6662
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
068.0136820TELE
VT
101YM0800X
Mental Health Counselor
TPMC6693
FL
101YP2500X
Professional Counselor
Primary
10474-125
WI
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/27/2021
Last updated
04/17/2026
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