Provider Demographics
NPI:1568780567
Name:NICHOLSON, MARGARET GRETA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:GRETA
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 JACKSON ST STE B
Mailing Address - Street 2:608-B
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-2656
Mailing Address - Country:US
Mailing Address - Phone:252-537-4005
Mailing Address - Fax:252-537-0329
Practice Address - Street 1:608 JACKSON ST STE B
Practice Address - Street 2:608-B
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-2656
Practice Address - Country:US
Practice Address - Phone:252-537-4005
Practice Address - Fax:252-537-0329
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7437101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health