MEDICARE: HALLIE ELISABETH NICHOLLS LPC-ASSOCIATE

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
1	101YM0800X	Mental Health Counselor	97915	TX

General Provider Information

NPI Number	:	1851253520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALLIE ELISABETH NICHOLLS LPC-ASSOCIATE

Provider Business Mailing Address
First Line	:	15000 PARK ROW APT 116
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-4163
Country	:	US
Telephone Number	:	318-470-4293
Fax Number	:

Provider Business Practice Location Address
First Line	:	8215 LONG POINT RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-2059
Country	:	US
Telephone Number	:	713-364-5867
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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