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General NPI Number Information
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NPI Number | 1669774535
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Entity Type | Organization
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Legal Business Name | MCNICHOLL COUNSELING, P.C.
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Dates
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Enumeration Date | 11/29/2010
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 201 W SPRINGFIELD AVE STE 1201
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City | CHAMPAIGN
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State | IL
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Zip | 61820-6385
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Country | US
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Telephone | 217-722-9079
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Fax | 217-501-4322
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Provider Business Mailing Address
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Address Line | 201 W SPRINGFIELD AVE STE 1201
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City | CHAMPAIGN
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State | IL
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Zip | 61820-6385
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Country | US
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Telephone | 217-722-9079
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Fax | 217-501-4322
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Authorized Official
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Title or Position | PRESIDENT-CEO
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Name | ROBERT J MCNICHOLL
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Credential | LCSW
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Telephone | 217-722-9079
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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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