Individual
CARRIE A NICKLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
109 N 48TH ST, SPRINGDALE, AR 72762-3743
(303) 905-9025
(479) 358-1493
Mailing address
3960 W OWL CREEK PL, FAYETTEVILLE, AR 72704-6237
(303) 905-9025
(479) 358-1493
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P1108056
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227848719
—
AR
Enumeration date
07/28/2008
Last updated
01/23/2025
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