Provider Demographics
NPI:1598358384
Name:NICK OF TIME SERVICES LLC
Entity Type:Organization
Organization Name:NICK OF TIME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LSATP, MAC, SAP
Authorized Official - Phone:805-955-9259
Mailing Address - Street 1:PO BOX 37235
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-7235
Mailing Address - Country:US
Mailing Address - Phone:804-955-9259
Mailing Address - Fax:
Practice Address - Street 1:7633 HULL STREET RD STE 300
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-6481
Practice Address - Country:US
Practice Address - Phone:804-918-2444
Practice Address - Fax:804-918-2705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty