Healthcare Provider Details

I. General information

NPI: 1043389224
Provider Name (Legal Business Name): AMY C. NICHOLSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OAK PLZ SUITE 206
ASHEVILLE NC
28801-3008
US

IV. Provider business mailing address

1 OAK PLZ SUITE 206
ASHEVILLE NC
28801-3008
US

V. Phone/Fax

Practice location:
  • Phone: 828-252-2501
  • Fax: 828-252-2701
Mailing address:
  • Phone: 828-252-2501
  • Fax: 828-252-2701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC003684
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: