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General NPI Number Information
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NPI Number | 1649863754
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Entity Type | Organization
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Legal Business Name | AMBERLY NICHOLS, LCSW, LLC
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Dates
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Enumeration Date | 02/19/2021
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 311 W HIGH ST
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City | ELKHART
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State | IN
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Zip | 46516-2827
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Country | US
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Telephone | 574-262-3597
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Fax |
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Provider Business Mailing Address
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Address Line | 3127 NORTHVIEW DR
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City | ELKHART
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State | IN
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Zip | 46514-6748
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Country | US
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Telephone | 574-215-8313
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | AMBERLY NICHOLS
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Credential |
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Telephone | 574-215-8313
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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 |
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License Number State |
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