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Contact Information

DEBORAH A NICHOLS, LCSW
509 MDG
331 SIJAN AVENUE
WHITEMAN AFB, MO65305
 Phone: 660-687-4412
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for DEBORAH A NICHOLS · (Female)

NPI # 1336184985
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 06/18/2006
Last updated 11/30/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • MO License # 004672
  • MO License # SW004672
  • MO Medicaid 497884338
  • MO Other 23810 BCBS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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