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Individual

ALEX EDWIN ALAN NICKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
5401 S PARK TERRACE AVE UNIT 104B, GREENWOOD VILLAGE, CO 80111-3437
(970) 481-7196

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC.00112315
CO
101YM0800X
Mental Health Counselor
Primary
ACD.0001376

Other

Enumeration date
10/31/2024
Last updated
10/31/2024
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