Nickels, Mark Thomas

Nickels, Mark Thomas is an individual health care provider with primary practice located at 96 South St Ware, Ware MA 01082-1616. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Nickels, Mark Thomas can be contacted via phone (413) 967-6241.

Contact Information

Primary practice address
96 South St Ware Ware MA 01082-1616
Phone: (413) 967-6241
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 11077 Massachusetts

Profile Details

NPI number 1124429840
LBN Legal business name Nickels, Mark Thomas
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2014
Last updated Dec 11th, 2023 - about 2 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 1124429840 NPPES
Massachusetts MEDICAID 1300881

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