Provider Demographics
NPI:1245395334
Name:NICHOLS, LAURA (LCSW, BCD)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3418 43RD AVENUE CT
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-7213
Mailing Address - Country:US
Mailing Address - Phone:910-813-1163
Mailing Address - Fax:
Practice Address - Street 1:3418 43RD AVENUE CT
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-7213
Practice Address - Country:US
Practice Address - Phone:910-813-1163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical