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Individual

NICHOLAS GARY CLEMENT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LMSW

Contact information

Practice address
845 W CENTER ST # L206, POCATELLO, ID 83204-4205
(208) 705-0506
Mailing address
711 GOLF DR, POCATELLO, ID 83204-3733
(208) 705-0506

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-8861356
ID

Other

Enumeration date
06/22/2020
Last updated
11/18/2025
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