person
Jody Nichols
Addiction (Substance Use Disorder) Counselor in Vidalia, Louisiana
NPI 1679124739

Jody Nichols is an Addiction (Substance Use Disorder) Counselor based in Vidalia, LA and is specialized in Addiction (Substance Use Disorder). Jody Nichols practices in Vidalia, LA. The NPI Number for Jody Nichols is 1679124739 and holds a License No. CIT-5033 (Louisiana).

The current practice location address for Jody Nichols is 806 Carter St, Vidalia, LA and can be reached out via phone at 318-734-0034 and via fax at 601-493-5898.

Location: 806 Carter St, Vidalia, LA, 71373-3206
person
Provider Profile Details
NPI Number
1679124739
Provider Name
Jody Nichols
Credential
Provider Entity Type
Individual
Gender
Male
Address
806 Carter St, Vidalia, LA, 71373-3206
Phone Number
318-734-0034
Fax Number
601-493-5898
Provider Enumeration Date
09/20/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5033 01 LA STATE OF LOUISIANA ADDICTIVE DISORDER REGULATORY AUTHORITY
institution
Provider Business Practice Location Address Details
Address
806 Carter St
City
State
Zip
71373-3206
Phone Number
318-734-0034
Fax Number
601-493-5898
person
Provider Business Mailing Address Details
Address
806 Carter St
City
State
Zip
71373-3206
Phone Number
318-734-0034
Fax Number
601-493-5898
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
CIT-5033 (Louisiana)
Definition
Definition to come...
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