Individual provider · Type 1 NPI

Nicole Lee Douglas, ASSOCIATE MFT

Mental Health Counselor · Santa Rosa, CA

NPI number 1154956829 Active

Practice location

3434 Mendocino Ave # A
Santa Rosa, CA 95403-2274

Call (707) 284-1978 Map

Mailing address

1757 Avila Ranch Dr
Petaluma, CA 94954-8522

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X112167 (CA)

Mental Health Counselor: Definition to come...

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About NPI 1154956829

Nicole Lee Douglas, ASSOCIATE MFT's National Provider Identifier is 1154956829, issued on Mar 3, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Santa Rosa, CA. The record was last updated on Mar 3, 2020.