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Provider Information for 1467129460


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NICOLE LEMBO MA


Sex: Female

NPI: 1467129460
Last Updated: 2024-05-13
Certification Date: 2024-05-13

Details

NameValue
NPI1467129460
Enumeration Date2021-08-26
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 2801 BERTHOLET BLVD STE 301
VALPARAISO, IN 46383-7959
United States

Phone: 219-323-3311 | Fax:
 
Primary Practice Address 1265 S LAKE PARK AVE
HOBART, IN 46342-5961
United States

Phone: 219-323-3311 | Fax:
 
Secondary Practice Address(es)

2801 BERTHOLET BLVD STE 301
VALPARAISO, IN 46383-7959
United States

Phone: 219-323-3311 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Direct Messaging Address
nlembo@pillarstherapy.com
work email
Direct work email 1265 S Lake Park Ave
Hobart, IN 46342-5961
United States
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthIN
No 101YM0800X - Counselor - Mental HealthIN39004936A