Individual
NICOLE WHEATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
411 E CHESTNUT ST # 5A6B, LOUISVILLE, KY 40202-1713
(502) 588-4940
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3683
KY
Other
Enumeration date
10/28/2013
Last updated
10/29/2020
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