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Individual

MS. AMBER NICKOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA

Contact information

Practice address
1001 N MARKET ST, MOUNT CARMEL, IL 62863
(618) 263-4970
(618) 263-4837
Mailing address
504 MICAH DR, OLNEY, IL 62450-4720
(618) 395-4306
(618) 395-4507

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
01/20/2015
Last updated
07/17/2018
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