Provider Demographics
NPI:1083390868
Name:NICHOLS, SECILY LINKER (LCMHCA)
Entity Type:Individual
Prefix:
First Name:SECILY
Middle Name:LINKER
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8825 COUNTY LINE RD.
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:NC
Mailing Address - Zip Code:28124
Mailing Address - Country:US
Mailing Address - Phone:704-796-7167
Mailing Address - Fax:
Practice Address - Street 1:2620 W MAIN ST.
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001
Practice Address - Country:US
Practice Address - Phone:980-581-8144
Practice Address - Fax:980-581-8148
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18899101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health