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Individual

MR. ADAM L NICKELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
3270 E 17TH ST # 131, AMMON, ID 83406-6758
(208) 534-6568
Mailing address
3270 E 17TH ST # 131, AMMON, ID 83406-6758
(208) 534-6568

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
14206814-3501
UT
101YM0800X
Mental Health Counselor
LCSW-36181
ID
1041C0700X
Clinical Social Worker
14206814-3501
UT
1041C0700X
Clinical Social Worker
Primary
LCSW- 36181
ID

Other

Enumeration date
08/05/2014
Last updated
09/25/2025
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