Provider Demographics
NPI:1881258119
Name:NICHOLS AND HILL COUNSELING AND THERAPY SERVICES, PLLC
Entity type:Organization
Organization Name:NICHOLS AND HILL COUNSELING AND THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC/MHSP, LMFT
Authorized Official - Phone:931-310-8338
Mailing Address - Street 1:121 TAFT STORY RD
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556-5894
Mailing Address - Country:US
Mailing Address - Phone:931-310-8338
Mailing Address - Fax:
Practice Address - Street 1:3636 PICKETT PARK HWY
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-5881
Practice Address - Country:US
Practice Address - Phone:931-310-8338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ024569Medicaid