Individual
NICHOLAS LEROY TIEKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LCADC
Contact information
Practice address
580 W 5TH ST, RENO, NV 89503-4407
(775) 786-4673
Mailing address
580 W 5TH ST, RENO, NV 89503-4407
(775) 786-4673
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
07010-LC
NV
1041C0700X
Clinical Social Worker
Primary
9739-C
NV
Other
Enumeration date
02/16/2015
Last updated
02/09/2022
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