Provider Demographics
NPI:1003315128
Name:NICHOLS, BRANDEE (LCSW)
Entity Type:Individual
Prefix:
First Name:BRANDEE
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 W. STAN SCHLUETER LOOP, SUITE 101
Mailing Address - Street 2:#136
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549
Mailing Address - Country:US
Mailing Address - Phone:254-307-0626
Mailing Address - Fax:
Practice Address - Street 1:902 N 10TH ST
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-4829
Practice Address - Country:US
Practice Address - Phone:254-336-6818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-04
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX514471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical