Organization
BRIAN NICKERSON COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN NICKERSON MSW (PSYCHOTHERAPIST)
(312) 561-6669
Entity
Organization
Contact information
Practice address
2501 CHATHAM RD STE N, SPRINGFIELD, IL 62704-4188
(312) 561-6669
Mailing address
2501 CHATHAM RD STE N, SPRINGFIELD, IL 62704-4188
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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