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NPI Code Detail

MEDICARE: WILLIAM J NICHOLS LPC

MEDICARE: WILLIAM J NICHOLS LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor12623TX
2106H00000XMarriage & Family Therapist2748TX

General Provider Information

NPI Number : 1063522688
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM J NICHOLS LPC
Provider Business Mailing Address
First Line : 301 S CENTER ST
Second Line : STE, 214
City : ARLINGTON
State : TX
Zip : 76010-7139
Country : US
Telephone Number : 817-276-6412
Fax Number : 817-276-6438
Provider Business Practice Location Address
First Line : 301 S CENTER ST
Second Line : STE, 214
City : ARLINGTON
State : TX
Zip : 76010-7139
Country : US
Telephone Number : 817-276-6412
Fax Number : 817-276-6438
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 08/09/2009

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