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Individual

NICHOLE L NOLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW, LISW-CP

Contact information

Practice address
726 PENN IVY ST, MOSES LAKE, WA 98837-2790
(509) 864-0860
Mailing address
172 OLDE TOWNE WAY UNIT 4, MYRTLE BEACH, SC 29588-1502
(509) 864-0860

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1041C0700X
Clinical Social Worker
LW61470965
WA
1041C0700X
Clinical Social Worker
Primary
SW.18040CP
SC

Other

Enumeration date
06/19/2013
Last updated
07/15/2025
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