MEDICARE: MR. WILBERT SINCLAIR NICHOLSON JR. CSCA

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CSAC-22055	NC

General Provider Information

NPI Number	:	1699148205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILBERT SINCLAIR NICHOLSON JR. CSCA

Provider Business Mailing Address
First Line	:	10174 NC HIGHWAY 305
Second Line	:
City	:	JACKSON
State	:	NC
Zip	:	27845-9685
Country	:	US
Telephone Number	:	919-384-6033
Fax Number	:

Provider Business Practice Location Address
First Line	:	10174 NC HIGHWAY 305
Second Line	:
City	:	JACKSON
State	:	NC
Zip	:	27845-9685
Country	:	US
Telephone Number	:	919-384-6033
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2015
Last Update Date	:	11/04/2015

Similar Medicare Providers

1457192817 — MR. VICTOR L WOLFE RPH
Practice Location Address:

9864 SILICA RD
NORTH JACKSON, OH
44451-9685

Practice Phone: 330-718-0647
Practice Fax:

1740268598 — RAVEN LIONEL DELOATCH MD
Practice Location Address:

9425 NC HIGHWAY 305
JACKSON, NC
27845-9679

Practice Phone: 252-534-1661
Practice Fax: 252-534-2841

1689626178 — RURAL HEALTH GROUP, INC.
Practice Location Address:

9425 NC 305 HWY
JACKSON, NC
27845

Practice Phone: 252-534-1661
Practice Fax: 252-534-2841

1356396428 — NORTHAMPTON COUNTY
Practice Location Address:

9495 NC 305 HIGHWAY
JACKSON, NC
27845-0635

Practice Phone: 252-534-5841
Practice Fax: 252-534-1045

1013951896 — TAR RIVER LTC GROUP, LLC
Practice Location Address:

200 HAMPTON WOODS COMPLEX
JACKSON, NC
27845-9503

Practice Phone: 252-534-0131
Practice Fax: 252-534-9926

1144313578 — FUTRELL PHARMACY SERVICE INC
Practice Location Address:

119 W JEFFERSON ST
JACKSON, NC
27845-9599

Practice Phone: 252-534-6001
Practice Fax: 252-534-1906

Directions to “ MR. WILBERT SINCLAIR NICHOLSON JR. CSCA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.