Lacey A Nichols, LCSW
Social Worker, Clinical in The Dalles, OR. Individual provider (NPI-1).
NPI number1124452008
StatusActive
Last updated in NPPESNov 2, 2023
Details
- NPI
- 1124452008
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Lacey A Nichols
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 27, 2013
- Certification date
- Nov 2, 2023
- Last updated
- Nov 2, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | L11457 | OR | Yes |
Practice location
1210 Dry Hollow Rd Ste 4 1/2The Dalles, OR 97058-3167
Phone 541-240-8938
Mailing address
1210 Dry Hollow Rd Ste 4 1/2The Dalles, OR 97058-3167
Phone 541-240-8938
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