Provider Demographics
NPI:1982277851
Name:NICHOLS, BRITTANY SHAW (LCSWA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:SHAW
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 WILLIAMSON RD STE 207
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-5917
Mailing Address - Country:US
Mailing Address - Phone:704-360-3641
Mailing Address - Fax:
Practice Address - Street 1:378 WILLIAMSON RD STE 207
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-5917
Practice Address - Country:US
Practice Address - Phone:704-360-3641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0166061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical