| Nichole Peralta Azor, Pllc | |
|
750 Beaver Creek School Rd West Jefferson NC 28694-7118 | |
| (308) 249-7853 | |
| (531) 248-4687 |
| Full Name | Nichole Peralta Azor, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 750 Beaver Creek School Rd, West Jefferson, North Carolina |
| Authorized Official Name and Position | Nichole Peralta Azor (LIMHP, LPC, LADC) |
| Authorized Official Contact | 3082497853 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nichole Peralta Azor, Pllc 206 Beaver Creek Estate Way West Jefferson NC 28694-9383 Ph: (308) 249-7853 | Nichole Peralta Azor, Pllc 750 Beaver Creek School Rd West Jefferson NC 28694-7118 Ph: (308) 249-7853 |
| NPI Number | 1881405991 |
|---|---|
| Provider Enumeration Date | 01/17/2025 |
| Last Update Date | 01/17/2025 |
| Certification Date | 01/17/2025 |
| Medicare PECOS PAC ID | 3072037670 |
|---|---|
| Medicare Enrollment ID | O20250404000726 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881405991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Nichole Peralta Azor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598042467 PECOS PAC ID: 8123433315 Enrollment ID: I20250404000970 |
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