Organization
NICKLES COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL VENETA NICKLES LCSW (PSYCHOTHERAPIST)
(608) 256-5115
Entity
Organization
Contact information
Practice address
401 WISCONSIN AVE, MADISON, WI 53703-1487
(608) 256-5115
(608) 256-5116
Mailing address
401 WISCONSIN AVE, MADISON, WI 53703-1487
(608) 256-5115
(608) 256-5116
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2843-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780138776
—
WI
Enumeration date
08/02/2018
Last updated
08/02/2018
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