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Organization
EBANYSANGEL
Active
Organization
EBANYSANGEL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICHOLE LYNN NOLAN LICSW (CLINICAL SOCIAL WORKER)
(509) 864-0860
Entity
Organization
Contact information
Practice address
172 OLDE TOWNE WAY UNIT 4, MYRTLE BEACH, SC 29588-1502
(509) 864-0860
Mailing address
172 OLDE TOWNE WAY UNIT 4, MYRTLE BEACH, SC 29588-1502
(509) 864-0860
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
08/25/2026
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