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NPI Code Detail

MEDICARE: CAM TU NICHOLS LCSW

MEDICARE:   CAM TU  NICHOLS  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker082656NY

General Provider Information

NPI Number : 1811497936
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAM TU NICHOLS LCSW
Provider Business Mailing Address
First Line : 170 W 1ST ST S
Second Line :
City : FULTON
State : NY
Zip : 13069-2231
Country : US
Telephone Number : 315-720-3161
Fax Number :
Provider Business Practice Location Address
First Line : 29 E CAYUGA ST
Second Line :
City : OSWEGO
State : NY
Zip : 13126-1241
Country : US
Telephone Number : 315-326-4100
Fax Number : 315-326-4229
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2018
Last Update Date : 06/20/2022

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Directions to “ CAM TU NICHOLS LCSW” Practice Location

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