Vredenburg, Nicole Lynn

Vredenburg, Nicole Lynn is an sole proprietor health care provider with primary practice located at 4302 W Broward Blvd Suite 800, Plantation FL 33317-3780. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Agencies / Foster Care Agency. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Vredenburg, Nicole Lynn can be contacted via phone (954) 854-6533.

Contact Information

Primary practice address
4302 W Broward Blvd Suite 800 Plantation FL 33317-3780
Phone: (954) 854-6533
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW9372 Florida
Agencies / Foster Care Agency 253J00000X

Profile Details

NPI number 1558497719
LBN Legal business name Vredenburg, Nicole Lynn
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 24th, 2007
Last updated Jun 3rd, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558497719 NPPES
Florida MEDICAID 767163600

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