Individual
MS. BEVERLY GALE NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC, CADC
Contact information
Practice address
4001 N CLASSEN BLVD, STE 105, OKLAHOMA CITY, OK 73118-2685
(405) 524-2424
(405) 525-3677
Mailing address
1719 FREMONT DR, OKLAHOMA CITY, OK 73120-3909
(405) 838-8535
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
371
OK
101YP2500X
Professional Counselor
Primary
5699
OK
251S00000X
Community/Behavioral Health Agency
5699
OK
Other
Enumeration date
04/17/2007
Last updated
09/05/2023
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