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Individual

KYLE JAMES NICHOLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LSWAIC

Contact information

Practice address
6505 216TH ST SW STE 100, MOUNTLAKE TERRACE, WA 98043-2089
(206) 745-2426
Mailing address
20126 BALLINGER WAY NE # 322, SHORELINE, WA 98155-1117
(206) 745-2426

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
60153970
WA
1041C0700X
Clinical Social Worker
Primary
LW61470468
WA

Other

Enumeration date
10/26/2010
Last updated
12/19/2023
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