Provider Demographics
NPI:1356694772
Name:NICHOLLS, CHAVIS LEE (LCSW, LAC)
Entity type:Individual
Prefix:MR
First Name:CHAVIS
Middle Name:LEE
Last Name:NICHOLLS
Suffix:
Gender:M
Credentials:LCSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 AVENUE C APT F
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3200
Mailing Address - Country:US
Mailing Address - Phone:066-981-6194
Mailing Address - Fax:
Practice Address - Street 1:1220 AVENUE C APT F
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3200
Practice Address - Country:US
Practice Address - Phone:066-981-6194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT23521041C0700X
MT1378101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)