Individual
AUDRIE M NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1314 MAIN ST N, CARTHAGE, TN 37030-1054
(615) 594-5490
Mailing address
192 GRANT HWY, GORDONSVILLE, TN 38563-4550
(615) 594-5490
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSW0000008505
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LSW0000008505
BOARD OF SOCIAL WORKER LICENSURE
TN
Enumeration date
05/11/2021
Last updated
12/06/2024
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