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Individual
MR. KIRK LELAND NICKISON
Active
Individual
MR. KIRK LELAND NICKISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QBHS
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
OH
171M00000X
Case Manager/Care Coordinator
—
NULL
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/20/2018
Last updated
03/24/2025
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