Provider Demographics
NPI:1629298518
Name:NICHOLS, LUCY CAROLINE (LCSW, PIP)
Entity Type:Individual
Prefix:MS
First Name:LUCY
Middle Name:CAROLINE
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:LCSW, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 BIENVILLE CT
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2011
Mailing Address - Country:US
Mailing Address - Phone:205-515-7784
Mailing Address - Fax:
Practice Address - Street 1:4126 AUTUMN LN
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-5209
Practice Address - Country:US
Practice Address - Phone:205-515-7784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1853C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical