Healthcare Provider Details

I. General information

NPI: 1508242553
Provider Name (Legal Business Name): HOPE P NICHOLS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2015
Last Update Date: 07/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 PINE ST STE 2D
PHILADELPHIA PA
19107-6187
US

IV. Provider business mailing address

822 PINE ST STE 2D
PHILADELPHIA PA
19107-6187
US

V. Phone/Fax

Practice location:
  • Phone: 610-348-0309
  • Fax: 215-925-2228
Mailing address:
  • Phone: 610-348-0309
  • Fax: 215-925-2228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number#MF000715
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: