| Jody Nichols, | |
|
806 Carter St, Vidalia, LA 71373-3206 | |
| (318) 734-0034 | |
| (601) 493-5898 |
| Full Name | Jody Nichols |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 806 Carter St, Vidalia, Louisiana |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679124739 | NPI | - | NPPES |
| 5033 | Other | LA | STATE OF LOUISIANA ADDICTIVE DISORDER REGULATORY AUTHORITY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CIT-5033 (Louisiana) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jody Nichols, 806 Carter St, Vidalia, LA 71373-3206 Ph: (318) 734-0034 | Jody Nichols, 806 Carter St, Vidalia, LA 71373-3206 Ph: (318) 734-0034 |
Dominique Trimble, Counselor Medicare: Not Enrolled in Medicare Practice Location: 211 S Spruce St, Vidalia, LA 71373 Phone: 225-421-7183 | |
Lynncoy Thornburg, Counselor Medicare: Not Enrolled in Medicare Practice Location: 204 Airport Rd, Vidalia, LA 71373 Phone: 318-323-1300 Fax: 318-323-1400 | |
Kimberly Simpson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 204 Airport Rd, Vidalia, LA 71373 Phone: 318-323-1300 Fax: 318-323-1400 | |
Amber J Johnson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1644 Carter St, Vidalia, LA 71373 Phone: 313-414-3065 | |
Valerie Jackson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1644 Carter St, Suite 2, Vidalia, LA 71373 Phone: 318-414-3065 | |
Doris Jean Jefferson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 204 Airport Rd, Vidalia, LA 71373 Phone: 318-323-1300 Fax: 318-323-1400 | |
Victoria Profit, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1644 Carter St # B, Vidalia, LA 71373 Phone: 318-414-3065 |