Provider Demographics
NPI:1841834777
Name:BETH NICHOLS COUNSELING, LLC
Entity type:Organization
Organization Name:BETH NICHOLS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-465-4794
Mailing Address - Street 1:7001 CHARLES RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-3608
Mailing Address - Country:US
Mailing Address - Phone:443-465-4794
Mailing Address - Fax:
Practice Address - Street 1:1122 KENILWORTH DR
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2139
Practice Address - Country:US
Practice Address - Phone:443-465-4794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health