NICOLE LYNN OUTLAW LAC
NPI 1700597234
Counselor - Mental Health in Glendale, AZ

Q: What is Nicole Outlaw's NPI number?

The NPI number for Nicole Outlaw is 1700597234. It was assigned to this individual provider in the NPPES registry on December 6, 2022.

Q: What is Nicole Outlaw's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Outlaw was last updated on December 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 06, 2022

17505 N 79TH AVE STE 311G, GLENDALE, AZ 85308(623) 876-2029 Get Directions Write a Review

NPPES record last updated: December 6, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Nicole Lynn Outlaw Lac NPPES

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

NICOLE LYNN OUTLAW LAC (NPI 1700597234) is an individual mental health provider in Glendale, Arizona, licensed in Arizona (LAC-21448) and active in the NPI registry since December 2022.

NPPES Registry Identity

NPI1700597234

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameNICOLE LYNN OUTLAWCredential: LAC

Location Address17505 N 79TH AVE STE 311GGlendale, AZ 85308-8730

Mailing Address6117 N 12th St Unit 7Phoenix, AZ 85014-1718 · (928) 900-3008

Phone(623) 876-2029

Sole ProprietorNo

Enumeration DateDecember 6, 2022

NPPES CertifiedDecember 6, 2022

✔ NPI 1700597234 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in AZ · LAC-21448

17505 N 79TH AVE STE 311G, Glendale, AZ 85308

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Other Providers at the Same Location NPPES 2

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

ELISA NOEL HINER BASS

Behavior Technician

17505 N 79TH AVE STE 311G
GLENDALE, AZ 85308

Maricopa County (623) 876-2029

ROBIN LYNN PUCKETT MAPC LAC

Counselor

17505 N 79TH AVE STE 311G
GLENDALE, AZ 85308

Maricopa County (623) 876-2029

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Outlaw's NPI number?

The NPI number for Nicole Outlaw is 1700597234. It was assigned to this individual provider in the NPPES registry on December 6, 2022.

Where is Nicole Outlaw located?

Nicole Outlaw practices at 17505 N 79th Ave Ste 311G, Glendale, AZ 85308. The listed phone number is (623) 876-2029.

What is Nicole Outlaw's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Nicole Outlaw was last updated on December 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.