Provider Demographics
NPI:1780887539
Name:NICHOLSON, JAMES JOSEPH (LMHC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:JOSEPH
Last Name:NICHOLSON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:JOSEPH
Other - Last Name:NICHOLSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:101 LISA LN
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-4323
Mailing Address - Country:US
Mailing Address - Phone:561-716-0863
Mailing Address - Fax:
Practice Address - Street 1:101 LISA LN
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-4323
Practice Address - Country:US
Practice Address - Phone:561-716-0863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5206101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health