Provider Demographics
NPI:1871771790
Name:ADAMS, NICHOLE LEAHNA (PSY D, ABPP)
Entity type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:LEAHNA
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PSY D, ABPP
Other - Prefix:DR
Other - First Name:NICHOLE
Other - Middle Name:
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, ABPP
Mailing Address - Street 1:132 JEFFERSON AVE
Mailing Address - Street 2:LUTHERAN COUNSELING CENTER
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2712
Mailing Address - Country:US
Mailing Address - Phone:516-741-0994
Mailing Address - Fax:516-306-0961
Practice Address - Street 1:132 JEFFERSON AVE
Practice Address - Street 2:LUTHERAN COUNSELING CENTER
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2712
Practice Address - Country:US
Practice Address - Phone:516-741-0994
Practice Address - Fax:516-868-0955
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017512103TC0700X, 103T00000X, 103TC2200X
NY1760064103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool