Nichols, Jennifer A

Nichols, Jennifer A is an individual health care provider with primary practice located at 200 Mason St Ste 11 , Onalaska WI 54650-7061. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Nichols, Jennifer A can be contacted via phone (608) 769-6784.

Contact Information

Primary practice address
200 Mason St Ste 11 Onalaska WI 54650-7061
Phone: (608) 769-6784
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 16360-131 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 4346-226 Wisconsin

Profile Details

NPI number 1871131482
LBN Legal business name Nichols, Jennifer A
Credentials LPC-IT, SAC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2019
Last updated Mar 1st, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871131482 NPPES
Wisconsin Other 4346-226 STATE OF WISCONSIN

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