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General NPI Number Information
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NPI Number | 1306257316
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Entity Type | Individual
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Provider Name | AMY NICHOLSON LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 05/13/2014
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 11350 MCCORMICK RD STE 800
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City | HUNT VALLEY
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State | MD
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Zip | 21031-1002
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Country | US
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Telephone | 410-800-2169
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Fax |
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Provider Business Mailing Address
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Address Line | 11350 MCCORMICK RD STE 800
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City | HUNT VALLEY
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State | MD
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Zip | 21031-1002
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Country | US
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Telephone | 410-800-2169
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14213
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | Q1-0012254
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License Number State | DE
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