Provider Demographics
NPI:1871944942
Name:NICHOLS, DANIEL (LCSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7597 E WINDROSE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-4745
Mailing Address - Country:US
Mailing Address - Phone:602-448-4055
Mailing Address - Fax:
Practice Address - Street 1:8889 E VIA LINDA
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5420
Practice Address - Country:US
Practice Address - Phone:480-284-7440
Practice Address - Fax:480-284-4178
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-137491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical