Provider Demographics
NPI:1508103987
Name:BILL NICHOLS LCSW, LCDC, PLLC
Entity Type:Organization
Organization Name:BILL NICHOLS LCSW, LCDC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW LCDC
Authorized Official - Phone:903-268-2796
Mailing Address - Street 1:PO BOX 8083
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75404-8083
Mailing Address - Country:US
Mailing Address - Phone:903-268-2796
Mailing Address - Fax:866-734-1205
Practice Address - Street 1:406 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-5610
Practice Address - Country:US
Practice Address - Phone:972-548-7590
Practice Address - Fax:866-734-1205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-06
Last Update Date:2013-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2359101YA0400X
TX5346261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty