Degomez, Nicole Carson

Degomez, Nicole Carson is an sole proprietor health care provider with primary practice located at 1016 W. University #202 , Flagstaff AZ 86001. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Degomez, Nicole Carson can be contacted via phone (928) 773-7774.

Contact Information

Primary practice address
1016 W. University #202 Flagstaff AZ 86001
Phone: (928) 773-7774
Fax: (928) 774-1148
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC-4026 Arizona

Profile Details

NPI number 1649423724
LBN Legal business name Degomez, Nicole Carson
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 3rd, 2008
Last updated Jul 13th, 2011 - about 15 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 1649423724 NPPES
Arizona MEDICAID 550534

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