Individual
MRS. NICOLE ELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LCAS
Contact information
Practice address
834 BRIDLEMINE DR, FUQUAY VARINA, NC 27526-3721
(919) 244-3121
Mailing address
834 BRIDLEMINE DR, FUQUAY VARINA, NC 27526-3721
(919) 244-3121
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
7011
NC
Other
Enumeration date
09/25/2006
Last updated
10/11/2013
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