Individual
NICHOLE PERALTA AZOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LIMHP, LPC, LADC
Contact information
Practice address
731 ILLINOIS ST, SIDNEY, NE 69162-1747
(308) 249-7853
(308) 365-5122
Mailing address
206 BEAVER CREEK ESTATE WAY, WEST JEFFERSON, NC 28694
(308) 249-7853
(308) 365-5122
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1256
NE
101YM0800X
Mental Health Counselor
Primary
1240
NE
101YP2500X
Professional Counselor
2125
NE
Other
Enumeration date
11/07/2011
Last updated
04/17/2024
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