Individual
KIM NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, NCC, CCTP, PMP
Contact information
Practice address
203 MABLE TRCE, MADISON, AL 35756-4394
(301) 742-1185
Mailing address
203 MABLE TRCE, MADISON, AL 35756-4394
(301) 742-1185
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC12633
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LC12633
BOARD OF PROFESSIONAL COUNSELORS&THERAPISTS
MD
Enumeration date
04/28/2022
Last updated
01/15/2026
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