Provider Demographics
NPI:1114278264
Name:NICHOLSON, LINDA (MS, LPC, LSATP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:MS, LPC, LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6414 SEVEN OAKS CT
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3131
Mailing Address - Country:US
Mailing Address - Phone:908-313-2176
Mailing Address - Fax:
Practice Address - Street 1:6414 SEVEN OAKS CT
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3131
Practice Address - Country:US
Practice Address - Phone:908-313-2176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00446800101YP2500X
VA0718000293101YA0400X
VA0701006634101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty