Ms. Nicole Ivory Goicuria
Mental Health Counselor
2514 N Broad St
Philadelphia
, Pennsylvania 19132-4013
Ms. Nicole Ivory Goicuria
Mental Health Counselor
2514 N Broad St
Philadelphia
, Pennsylvania 19132-4013
(215) 599-1041
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About
Features
Specialties
- Mental Health Counselor
Languages spoken
- English
Location
First Address
- Ms. Nicole Ivory Goicuria
- 2514 N Broad St
- Philadelphia, PA
- Zip : 19132-4013
- Fax : (215) 599-1041
- Phone : (215) 599-2808
Second Address
- Ms. Nicole Ivory Goicuria
- 2514 N Broad St
- Philadelphia, PA
- Zip : 19132-4013
- Fax : (215) 599-1041
- Phone : (215) 599-2808
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Is Ms. Nicole Ivory Goicuria a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 101YM0800X | Mental Health Counselor |
National Provider Identifier
| NPI | 1003096561 |
|---|---|
| Provider Name | Ms. Nicole Ivory Goicuria |
| First Address | Philadelphia, PA 19132-4013 |
| Second Address | Philadelphia, PA 19132-4013 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/11/2007 |
| Last Update Date | 13/11/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.