Individual provider · Type 1 NPI
Nicole Davis, MSW, LICSW, LADC
Mental Health Counselor · St. Paul Park, MN
NPI number
1457846313
Active
Practice location
940 Hastings Ave
St. Paul Park, MN 55071-1315
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 27532 (MN) |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 304395 (MN) |
Mental Health Counselor: Definition to come...
3 other providers at this address
About NPI 1457846313
Nicole Davis, MSW, LICSW, LADC's National Provider Identifier is 1457846313, issued on Jun 24, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in St. Paul Park, MN. The record was last updated on Oct 30, 2025.