Individual provider · Type 1 NPI

Mary Rose Nichols, LCSW, CADCIII

Addiction (Substance Use Disorder) Counselor · Enterprise, OR

NPI number 1477572188 Active

Practice location

207 SW 1st St
Enterprise, OR 97828-1203

Fax (541) 426-3035

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XL1978 (OR)
Clinical Social Worker 1041C0700XL1978 (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1477572188

Mary Rose Nichols, LCSW, CADCIII's National Provider Identifier is 1477572188, issued on Jul 19, 2006. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Enterprise, OR. The record was last updated on Feb 7, 2008.