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Individual
MR. MARK NICHOLS
Active
Individual
MR. MARK NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701006460
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701006460
LPC LICENSE #
VA
Enumeration date
01/02/2013
Last updated
07/12/2018
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