Individual
ALICE CATHERINE NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
5723 213TH ST SW, MOUNTLAKE TERRACE, WA 98043-2022
(620) 240-0979
Mailing address
5723 213TH ST SW, MOUNTLAKE TER, WA 98043-2022
(620) 240-0979
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1306
KS
1041C0700X
Clinical Social Worker
LW60713675
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069877
BLUE CROSS BLUE SHIELD
KS
05
—
200436850B
—
KS
01
—
207968
GREAT WEST HEALTH PARTNER
KS
01
—
564221
VALUE OPTIONS INC
VA
Enumeration date
10/02/2006
Last updated
07/17/2025
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