Individual provider · Type 1 NPI

Imogen Kieran Nicholas

Mental Health Counselor · Clinton, MS

NPI number 1851219398 Active

Practice location

604 Highway 80 W Ste R
Clinton, MS 39056-4108

Mailing address

7 Treeway Dr
Brandon, MS 39042-2301

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1851219398

Imogen Kieran Nicholas's National Provider Identifier is 1851219398, issued on Jul 9, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Clinton, MS. The record was last updated on Jul 9, 2026.