Provider Demographics
NPI:1578657912
Name:NICKENS, NORMA J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NORMA
Middle Name:J
Last Name:NICKENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E. WALNUT ST.
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713
Mailing Address - Country:US
Mailing Address - Phone:812-465-6214
Mailing Address - Fax:812-465-5646
Practice Address - Street 1:500 E. WALNUT ST.
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713
Practice Address - Country:US
Practice Address - Phone:812-465-6214
Practice Address - Fax:812-465-5646
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003450A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical