Basic Information
Provider Information
NPI: 1922329895
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZIPPIN
FirstName: NICOLE
MiddleName: A.
NamePrefix: MS.
NameSuffix:  
Credential: LCSW-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 E CARROLL ST RM 3581
Address2:  
City: SALISBURY
State: MD
PostalCode: 218015422
CountryCode: US
TelephoneNumber: 4105437119
FaxNumber:  
Practice Location
Address1: 100 E CARROLL ST
Address2:  
City: SALISBURY
State: MD
PostalCode: 218015493
CountryCode: US
TelephoneNumber: 8007495191
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/15/2010
LastUpdateDate: 10/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X15972MDY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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