Nicole Conrad, 106S00000X
Nicole Conrad, 106S00000X is a Mental Health Counselor in Fort Wayne, Indiana. Practices as a sole proprietor. Licensed in Indiana.
- Licensed in
- IN
- In the registry since
- 2019
- Specialties on file
- 2
Practice location Address checks out
908 Manck DrFort Wayne, IN 46814-8995
Phone: (260) 271-5285
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Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X (IN) |
|---|---|
| Behavior Technician | Taxonomy 106S00000X · Licence 25-482997 (IN) |
Record details
| NPI number | 1922654722 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | 106S00000X |
| Sole proprietor | Yes |
| NPI enumerated | August 16, 2019 |
| Last updated in NPPES | November 12, 2025 |
| Certification date | November 12, 2025 |
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