Individual
MS. CAROLYN J. NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
20955 VIRGINIA ST, SUITE B, SOUTHFIELD, MI 48076-2381
(248) 219-5493
(248) 354-3816
Mailing address
20955 VIRGINIA ST, SUITE B, SOUTHFIELD, MI 48076-2381
(248) 219-5493
(248) 354-3816
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
N242108275628
MI
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
06/17/2008
Last updated
06/17/2008
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