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General NPI Number Information
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NPI Number | 1841151289
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Entity Type | Individual
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Provider Name | AMANDA KATHRYN NICHOLSON PSYD
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Gender | Female
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 1000 PROGRESS PL
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City | CONCORD
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State | NC
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Zip | 28025-2449
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Country | US
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Telephone | 866-272-7826
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Fax |
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Provider Business Mailing Address
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Address Line | 2021 MORTON ST APT 223
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City | CHARLOTTE
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State | NC
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Zip | 28208-5340
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Country | US
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Telephone |
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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