Individual
MR. KIRK LELAND NICKISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QBHS
Contact information
Practice address
303 OFFNERE ST, PORTSMOUTH, OH 45662-4655
(740) 876-9369
Mailing address
303 OFFNERE ST, PORTSMOUTH, OH 45662-4655
(740) 876-9369
(740) 876-9213
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OH
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/20/2018
Last updated
03/24/2025
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