Individual
CHARMAINE L NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Contact information
Practice address
1324 CENTRAL AVE W # 14, GREAT FALLS, MT 59404-3971
(406) 788-1977
Mailing address
5705 62ND AVE SW, GREAT FALLS, MT 59404-5244
(406) 771-7280
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
488LCPC
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074896
LCPC BLUE CROSS
MT
05
—
250240
—
MT
Enumeration date
02/01/2007
Last updated
07/09/2007
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