Individual provider · Type 1 NPI
Michael R. Nicholson, CSAC CSIT
Addiction (Substance Use Disorder) Counselor · Hales Corners, WI
NPI number
1619101847
Active
Practice location
10940 W Forest Home Ave
Hales Corners, WI 53130-2516
Fax (815) 387-2569
Mailing address
1021 N Mulford Rd
Rockford, IL 61107-3877
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 15466-132 (WI) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1619101847
Michael R. Nicholson, CSAC CSIT's National Provider Identifier is 1619101847, issued on May 1, 2009. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Hales Corners, WI. The record was last updated on Apr 26, 2016.