Organization
PRIDE MENTAL HEALTH CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE ANN MILLICH APRN (OWNER)
(239) 778-4405
Entity
Organization
Contact information
Practice address
3606 ENTERPRISE AVE STE 200, NAPLES, FL 34104-3670
(239) 307-2400
(239) 734-9968
Mailing address
3606 ENTERPRISE AVE STE 200, NAPLES, FL 34104-3670
(239) 307-2400
(239) 734-9968
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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