Healthcare Provider Details

I. General information

NPI: 1649837394
Provider Name (Legal Business Name): CARA NICHOLSON, PSY.D. PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2019
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 N ARLINGTON HEIGHTS RD # WING200
ARLINGTON HEIGHTS IL
60004-1563
US

IV. Provider business mailing address

3250 N ARLINGTON HEIGHTS RD # WING200
ARLINGTON HEIGHTS IL
60004-1563
US

V. Phone/Fax

Practice location:
  • Phone: 872-810-3134
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CARA NICHOLSON
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 847-712-7300