NICOLE EILEEN BOSWELL MA, LPC, NCC - NPI 1447717384

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YP2500X and a focus in Professional.

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About Nicole Eileen Boswell Ma, Lpc, Ncc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE EILEEN BOSWELL MA, LPC, NCC (NPI 1447717384) is an individual professional provider in Homer Glen, Illinois, licensed in Illinois (178.014593) and active in the NPI registry since February 2019.

NPPES Registry Identity

NPI1447717384

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameNICOLE EILEEN BOSWELLCredential: MA, LPC, NCC

Location Address13728 W CAREFREE DRHomer Glen, IL 60491-8655

Mailing Address425 S Roosevelt Ave Apt 11Kankakee, IL 60901-3068 · (815) 341-2060

Phone(815) 955-8728

Fax(708) 966-4244

Sole ProprietorYes

Enumeration DateFebruary 27, 2019

✔ NPI 1447717384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in IL · 178.014593

13728 W CAREFREE DR, Homer Glen, IL 60491

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Other Names 1

Former Name (1)Nicole Pedone Ma, Lpc, Ncc

Other Identifiers 1

Other178.014593IL · Licensed Professional Counselor

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

POOJA JOSHI M.A., LPC, NCC

Counselor (Professional)