Ethridge, Nicole Darlene

Ethridge, Nicole Darlene is an individual health care provider with primary practice located at 5904 Warner Ave Unit 413 , Huntington Beach CA 92649-4670. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Ethridge, Nicole Darlene can be contacted via phone (909) 898-7886.

Contact Information

Primary practice address
5904 Warner Ave Unit 413 Huntington Beach CA 92649-4670
Phone: (909) 898-7886
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 37PC00899200 New Jersey
Behavioral Health & Social Service Providers / Counselor 101Y00000X 2018013675 Missouri
Behavioral Health & Social Service Providers / Professional 101YP2500X PC-0011186 Delaware
Behavioral Health & Social Service Providers / Professional 101YP2500X 16030 California

Profile Details

NPI number 1760974596
LBN Legal business name Ethridge, Nicole Darlene
Credentials MA, LPC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2018
Last updated Jan 5th, 2026 - about 9 months 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 1760974596 NPPES
Missouri MEDICAID 490055189

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