Provider Demographics
NPI:1518589340
Name:NICHOLS, HOLLY (LMHC)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 OAKLAND RD
Mailing Address - Street 2:
Mailing Address - City:WEST KINGSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02892-1745
Mailing Address - Country:US
Mailing Address - Phone:401-372-2628
Mailing Address - Fax:
Practice Address - Street 1:32 OAKLAND RD
Practice Address - Street 2:
Practice Address - City:WEST KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02892-1745
Practice Address - Country:US
Practice Address - Phone:401-372-2628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00344101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health