Individual
THERON ROBERT NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
211 N WATER ST, LAS CRUCES, NM 88001-1219
(505) 295-4182
(575) 520-2824
Mailing address
5305 MCNUTT RD, SANTA TERESA, NM 88008-8937
(575) 882-5100
(575) 882-1151
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CTB-2025-0065
NM
172V00000X
Community Health Worker
—
NM
Other
Enumeration date
09/29/2015
Last updated
10/22/2025
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