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Individual

DR. JOHN ARTHUR NICHOLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
113 BELMONT ST, BELMONT, MA 02478-3603
(617) 484-1042
Mailing address
4 RUMFORD RD, LEXINGTON, MA 02420-2209
(617) 484-1042

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
4101
MA
103TC0700X
Clinical Psychologist
Primary
4101
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
169987000
MAGELLAN HEALTH
MA
01
712923
TUFTS HEALTH PLAN
MA
01
W04075
BLUE CROSS AND BLUE SHIEL
MA
Enumeration date
11/15/2006
Last updated
03/30/2010
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