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General NPI Number Information
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NPI Number | 1508103987
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Entity Type | Organization
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Legal Business Name | BILL NICHOLS LCSW, LCDC, PLLC
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Dates
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Enumeration Date | 01/06/2013
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Last Update Date | 01/06/2013
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Provider Practice Location Address
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Address Line | 406 S CHESTNUT ST
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City | MCKINNEY
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State | TX
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Zip | 75069-5610
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Country | US
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Telephone | 972-548-7590
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Fax | 866-734-1205
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Provider Business Mailing Address
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Address Line | PO BOX 8083
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City | GREENVILLE
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State | TX
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Zip | 75404-8083
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Country | US
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Telephone | 903-268-2796
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Fax | 866-734-1205
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAN EDWARD NICHOLS
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Credential | LCSW LCDC
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Telephone | 903-268-2796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2359
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License Number State | TX
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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 | 534626
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License Number State | TX
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