Organization
FOUR GATES PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEIL R. NICHOLSON LCSW (CLINICAL SOCIAL WORKER)
(541) 301-3559
Entity
Organization
Contact information
Practice address
1651 SISKIYOU BLVD, ASHLAND, OR 97520-2400
(530) 643-7750
Mailing address
400 COVE RD, ASHLAND, OR 97520-9068
(541) 694-2721
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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