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Nicole Marie Diercks, LPC,CSAC,CCTP-II
Counselor in Manassas, Virginia
NPI 1841746146

Nicole Marie Diercks is a Counselor based in Manassas, VA. Nicole Marie Diercks practices in Manassas, VA and has the professional credentials of LPC,CSAC,CCTP-II. The NPI Number for Nicole Marie Diercks is 1841746146 and holds a License No. 6995-125 (Virginia).

The current practice location address for Nicole Marie Diercks is 7969 Ashton Ave, Manassas, VA and can be reached out via phone at 703-792-4175 and via fax at 703-792-7817. You can also correspond with Nicole Marie Diercks through the mailing address at 7969 ASHTON AVE, MANASSAS, VA - 20109-2885 (mailing address contact number: 703-792-4175).

Location: 7969 Ashton Ave, Manassas, VA, 20109-2885
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1841746146
Provider Name
Nicole Marie Diercks
Credential
LPC,CSAC,CCTP-II
Provider Entity Type
Individual
Gender
Female
Address
7969 Ashton Ave, Manassas, VA, 20109-2885
Phone Number
703-792-4175
Fax Number
703-792-7817
Provider Enumeration Date
08/28/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
14378296 05 VA
1295228120 05 WI
institution
Provider Business Practice Location Address Details
Address
7969 Ashton Ave
City
Manassas
State
Virginia
Zip
20109-2885
Phone Number
703-792-4175
Fax Number
703-792-7817
person
Provider Business Mailing Address Details
Address
7969 Ashton Ave
City
Manassas
State
Virginia
Zip
20109-2885
Phone Number
703-792-4175
Fax Number
703-792-7817
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
0701008933 (Virginia)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
6995-125 (Wisconsin)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
6995-125 (Wisconsin)
Definition
Definition to come...
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