Provider Demographics
NPI:1730644972
Name:NICHOLS, RICHELLE N (LMFT)
Entity type:Individual
Prefix:
First Name:RICHELLE
Middle Name:N
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1392
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91353-1392
Mailing Address - Country:US
Mailing Address - Phone:818-732-8114
Mailing Address - Fax:
Practice Address - Street 1:1228 N SCREENLAND DR
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2244
Practice Address - Country:US
Practice Address - Phone:818-732-8114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-01
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91484106H00000X
CA119870106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty