Woller, Nicole

Woller, Nicole is an sole proprietor health care provider with primary practice located at 5818 Se Agnew Rd , Belleview FL 34420-4020. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Woller, Nicole can be contacted via phone (561) 706-1004.

Contact Information

Primary practice address
5818 Se Agnew Rd Belleview FL 34420-4020
Phone: (561) 706-1004
Fax: (561) 892-0268
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X
Behavioral Health & Social Service Providers / Forensic 103TF0200X
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW8553 Florida

Profile Details

NPI number 1881735819
LBN Legal business name Woller, Nicole
Credentials PH.D., LCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 11th, 2007
Last updated Apr 22nd, 2020 - about 5 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 1881735819 NPPES
Florida Other 11758162 CAQH
Florida MEDICAID 767023100 CAQH

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