Individual
BREAH N NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC III
Contact information
Practice address
120 TWIN OAKS DR, JACKSON, OH 45640-9828
(740) 577-3450
(740) 577-3496
Mailing address
PO BOX 724, ATHENS, OH 45701-0724
(740) 592-6724
(740) 592-6728
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
165237
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2864002
—
OH
Enumeration date
02/27/2018
Last updated
11/24/2025
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