Individual
ELIZABETH NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2301 YALE BLVD SE, ALBUQUERQUE, NM 87106-4228
(505) 272-1379
Mailing address
7401 PURPLE FRINGE RD SW, ALBUQUERQUE, NM 87121-6382
(219) 308-8855
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C-06307
NM
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
34008210A
IN
Other
Enumeration date
06/26/2017
Last updated
12/02/2024
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