Provider Demographics
NPI:1942754619
Name:NICHOLS, CASEY (BSW)
Entity type:Individual
Prefix:MISS
First Name:CASEY
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 20TH ST S
Mailing Address - Street 2:4TH FLOOR RM 479
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2610
Mailing Address - Country:US
Mailing Address - Phone:205-934-9715
Mailing Address - Fax:
Practice Address - Street 1:UAB COMMUNITY PSYCHIATRY
Practice Address - Street 2:908 20TH STREET SOUTH RM 479
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0001
Practice Address - Country:US
Practice Address - Phone:205-934-9715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical