Provider Demographics
NPI:1982308169
Name:NICHOLS, TASHAWN MONIQUE (LPC)
Entity Type:Individual
Prefix:
First Name:TASHAWN
Middle Name:MONIQUE
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-2926
Mailing Address - Country:US
Mailing Address - Phone:866-583-6003
Mailing Address - Fax:
Practice Address - Street 1:250 SHADY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4316
Practice Address - Country:US
Practice Address - Phone:866-583-6003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014470101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional