Provider Demographics
NPI:1861149155
Name:NICHOLSON, A'SHAUNTE KATRICE (LCSWA, LCASA)
Entity type:Individual
Prefix:
First Name:A'SHAUNTE
Middle Name:KATRICE
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:LCSWA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405A S GLENBURNIE RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2603
Mailing Address - Country:US
Mailing Address - Phone:252-638-7875
Mailing Address - Fax:252-638-7586
Practice Address - Street 1:1405A S GLENBURNIE RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2603
Practice Address - Country:US
Practice Address - Phone:252-638-7875
Practice Address - Fax:252-638-7586
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30827101YA0400X
NCP0221661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)