Provider Demographics
NPI:1891088274
Name:NICHOLSON, TAMMY ANNE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:ANNE
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 PORTSMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:STRATHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03885-2228
Mailing Address - Country:US
Mailing Address - Phone:603-370-0663
Mailing Address - Fax:
Practice Address - Street 1:24 FRONT ST STE 304
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2774
Practice Address - Country:US
Practice Address - Phone:603-546-6176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8421101YA0400X
NH1154101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)