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General NPI Number Information
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NPI Number | 1871944942
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Entity Type | Individual
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Provider Name | DANIEL NICHOLS LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 8889 E VIA LINDA
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5420
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Country | US
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Telephone | 480-284-7440
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Fax | 480-284-4178
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Provider Business Mailing Address
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Address Line | 7597 E WINDROSE DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-4745
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Country | US
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Telephone | 602-448-4055
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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 | LCSW-13749
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License Number State | AZ
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