Nicole Witteboon, Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW3351 Issued in FL

Legal business name

NICOLE WITTEBOON, INC

Practice address

2855 North University Drive
Suite 200
Coral Springs, FL 33065-1403

Phone

(954) 344-9825

Fax

(954) 757-3232

NPI assigned

Feb 21, 2007

Last updated

Jun 24, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Nicole Weiner, LCWS

Title

President

Phone

(954) 344-9825

Specialties & licenses 1

Addresses

Other names 1

• Nicole Weiner, Inc Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435104000000",
    "number": "1588709083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 NORTH UNIVERSITY DRIVE",
            "address_2": "SUITE 200",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330651403",
            "telephone_number": "954-344-9825",
            "fax_number": "954-757-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 NORTH UNIVERSITY DRIVE",
            "address_2": "SUITE 200",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330651403",
            "telephone_number": "954-344-9825",
            "fax_number": "954-757-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE WITTEBOON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2015-06-24",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-344-9825",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCWS"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW3351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nicole Weiner, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Social Worker in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.