Individual
MR. MARK NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LPC
Contact information
Practice address
727 J CLYDE MORRIS BLVD STE A, NEWPORT NEWS, VA 23601-1507
(757) 595-3455
(757) 595-3456
Mailing address
727 J CLYDE MORRIS BLVD STE A, NEWPORT NEWS, VA 23601-1507
(757) 595-3455
(757) 595-3456
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701006460
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701006460
LPC LICENSE #
VA
Enumeration date
01/02/2013
Last updated
07/12/2018
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