NICOLE MARIE DIERCKS

FORT CAMPBELL, KY
NPI1841746146
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YP2500X Counselor, Professional
Additional Taxonomies101Y00000X Counselor
(Licence: VA  0701008933)
101Y00000X Counselor
(Licence: VA  0710103493)
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  6995-125)
101YM0800X Counselor, Mental Health
(Licence: WI  6995-125)
Enumeration Date2016-08-28
Last Update Date2024-09-30
Business Address
NICOLE MARIE DIERCKS LPC, CSAC, CCTP-II
650 JOEL DR
FORT CAMPBELL, KY 42223-5318
Phone number: 270-798-8727
Mailing Address
NICOLE MARIE DIERCKS LPC, CSAC, CCTP-II
7969 ASHTON AVE
MANASSAS, VA 20109-2885
Phone number: 703-792-4175