| Doctor Name: | MRS. NICOLE K. FOGEL |
| NPI Number: | 1962693929 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | SW9816 |
| Business Practice Address: | 4318 Sw Appleseed Rd Port St. Lucie, FL - 34953 |
| Business Phone Number: | 7723594103 |
| Business Fax Number: | |
| Mailing Address: | 4318 Sw Appleseed Rd, PORT ST LUCIE |
| State: | FL |
| Postal Code: | 349535488 |
| Phone Number: | 7723594103 |
| Fax Number: | |
| NPI Enumeration Date: | 08/06/2007 |
| NPI Last Update Date: | 07/26/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW9816 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |