Individual ProviderNicole HerreraSocial WorkerBehavioral Health & Social Service ProvidersPractice Address5965 S 900 E, Salt Lake City, UT 84121-1720(801) 263-7138PECOS EnrollmentBased on the most recent information from CMS, provider Nicole Herrera does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1285975102Provider TypeIndividualFull NameHerrera, NicoleCredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date3/4/2013Last Updated7/19/2016Contact InformationPractice LocationPractice Address5965 S 900 E, Salt Lake City, UT 84121-1720Phone(801) 263-7138FaxUnlisted FaxMailing LocationMailing Address5965 S 900 E, Salt Lake City, UT 84121-1720Phone(801) 263-7138FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense90763483501Utah