Individual
MICHAEL NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
12 KILLORAN DR, ESSEX JUNCTION, VT 05452-4607
(802) 399-6041
(802) 735-1008
Mailing address
12 KILLORAN DR, ESSEX JUNCTION, VT 05452-4607
(802) 399-6041
(802) 735-1008
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0104686
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6710533
—
VT
Enumeration date
06/14/2016
Last updated
08/02/2022
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