Provider Demographics
NPI:1639499668
Name:NICHOLAS, LORI DEMPSEY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:DEMPSEY
Last Name:NICHOLAS
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 1:100 FOUNTAIN AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-2771
Mailing Address - Country:US
Mailing Address - Phone:270-408-4192
Mailing Address - Fax:270-408-4194
Practice Address - Street 1:100 FOUNTAIN AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-2771
Practice Address - Country:US
Practice Address - Phone:270-408-4192
Practice Address - Fax:270-408-4194
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical