Individual
NICOLE GROCKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMFT
Contact information
Practice address
1321 WISCONSIN AVE NW, WASHINGTON, DC 20007-3311
(703) 867-2811
Mailing address
4500 EVERETT ST, KENSINGTON, MD 20895-4109
(703) 867-2811
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
0717001055
VA
106H00000X
Marriage & Family Therapist
Primary
LMFT000006
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0717001055
LICENSED MARRIAGE AND FAMILY THERAPIST
VA
01
—
LMFT000006
LICENSED MARRIAGE AND FAMILY THERAPIST
DC
Enumeration date
05/24/2016
Last updated
05/24/2016
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