Provider Demographics
NPI:1760719280
Name:NICHOLS, JOSEPH PATRICK (LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:NICHOLS
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5532
Mailing Address - Country:US
Mailing Address - Phone:256-810-7887
Mailing Address - Fax:256-712-1830
Practice Address - Street 1:414 E TUSCALOOSA ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-4726
Practice Address - Country:US
Practice Address - Phone:256-810-7887
Practice Address - Fax:256-712-1830
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2748101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional