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Individual

MR. PATRICK FRANCIS NICHOLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW CSAC

Contact information

Practice address
6502 GRAND TETON PLZ, MADISON, WI 53719-1047
(608) 827-7220
(608) 827-7223
Mailing address
2241 RYAN DR, DODGEVILLE, WI 53533-9274
(608) 827-7220
(608) 827-7223

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4082-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13683
ADDICTION COUNSELOR
WI
05
39644000
WI
01
4082-123
LICENSED SW
WI
Enumeration date
03/08/2007
Last updated
07/09/2007
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