Healthcare Provider Details

I. General information

NPI: 1083390868
Provider Name (Legal Business Name): SECILY LINKER NICHOLS LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 CHURCH ST N STE 245
CONCORD NC
28025-4525
US

IV. Provider business mailing address

8825 COUNTY LINE RD
MOUNT PLEASANT NC
28124-8896
US

V. Phone/Fax

Practice location:
  • Phone: 704-317-6110
  • Fax:
Mailing address:
  • Phone: 704-796-7167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number18899
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: