NICOLE MARIE DIERCKS

FORT CAMPBELL, KY
NPI1841746146
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: WI  6995-125)
Additional Taxonomies101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  16382-132)
101YP2500X Counselor, Professional
101Y00000X Counselor
(Licence: VA  0701008933)
Enumeration Date2016-08-28
Last Update Date2024-11-09
Business Address
NICOLE MARIE DIERCKS LPC, CSAC
650 JOEL DR
FORT CAMPBELL, KY 42223-5318
Phone number: 270-798-8727
Mailing Address
NICOLE MARIE DIERCKS LPC, CSAC
12761 ROCKWOOD LN
WOODBRIDGE, VA 22192-5015
Phone number: 512-887-2862