Provider Demographics
NPI:1174790786
Name:NICHOLAS, STEPHEN H (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:H
Last Name:NICHOLAS
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 N WALSH ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-4268
Mailing Address - Country:US
Mailing Address - Phone:775-315-9738
Mailing Address - Fax:888-891-3191
Practice Address - Street 1:407 N WALSH ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-4268
Practice Address - Country:US
Practice Address - Phone:775-315-9738
Practice Address - Fax:888-891-3191
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5834-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical