Individual
TERESA NICELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
803 S RUSK ST, AMARILLO, TX 79106-6648
(806) 599-8312
Mailing address
803 S RUSK ST, AMARILLO, TX 79106-6648
(806) 599-8312
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
58656
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16962
TX
Other
Enumeration date
02/23/2024
Last updated
03/12/2026
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