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General NPI Number Information
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NPI Number | 1043173859
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Entity Type | Individual
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Provider Name | WESLEY NICHOLLS LMHC
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Gender | Male
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 175 DERBY ST STE 21
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City | HINGHAM
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State | MA
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Zip | 02043-4052
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Country | US
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Telephone | 781-424-8119
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Fax |
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Provider Business Mailing Address
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Address Line | 433 S MAIN ST UNIT 2
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City | ATTLEBORO
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State | MA
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Zip | 02703-6439
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Country | US
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Telephone | 508-463-8611
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LMHC10005561
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License Number State | MA
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