Provider Demographics
NPI:1467946202
Name:NICHOLS, MONICA (MA)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 CHILTON RD
Mailing Address - Street 2:
Mailing Address - City:ARARAT
Mailing Address - State:NC
Mailing Address - Zip Code:27007-8040
Mailing Address - Country:US
Mailing Address - Phone:336-769-8342
Mailing Address - Fax:
Practice Address - Street 1:306 N WHITE ST
Practice Address - Street 2:
Practice Address - City:DOBSON
Practice Address - State:NC
Practice Address - Zip Code:27017-8938
Practice Address - Country:US
Practice Address - Phone:336-414-7794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-22765101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)