| Susan C Nicholson Phd, Lcsw Dba Thimble Shoals Counseling & Therapy Ce | |
|
703 Thimble Shoals Blvd A3 Newport News VA 23606-2576 | |
| (757) 873-3401 | |
| (757) 223-1165 |
| Full Name | Susan C Nicholson Phd, Lcsw Dba Thimble Shoals Counseling & Therapy Ce |
|---|---|
| Speciality | Social Worker |
| Location | 703 Thimble Shoals Blvd, Newport News, Virginia |
| Authorized Official Name and Position | Susan C Nicholson (OWNER, PRESIDENT) |
| Authorized Official Contact | 7578692361 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan C Nicholson Phd, Lcsw Dba Thimble Shoals Counseling & Therapy Ce 203 Woodburne Ln Newport News VA 23602-8363 Ph: (757) 869-2361 | Susan C Nicholson Phd, Lcsw Dba Thimble Shoals Counseling & Therapy Ce 703 Thimble Shoals Blvd A3 Newport News VA 23606-2576 Ph: (757) 873-3401 |
| NPI Number | 1033138227 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 06/25/2008 |
| Medicare PECOS PAC ID | 7113914060 |
|---|---|
| Medicare Enrollment ID | O20040430000592 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033138227 | NPI | - | NPPES |
| 228979000 | Other | VA | MAGELLAN |
| 567827 | Other | VA | MAMSI |
| 5774587 | Other | VA | AETNA |
| 1033138227 | Medicaid | VA | |
| 034810 | Other | VA | VALUE OPTIONS |
| 118556 | Other | VA | ANTHEM |
| 118556 | Other | VA | HEALTHKEEPERS |
| 081419 | Other | VA | SENTARA |
| 2130368 | Other | CIGNA | |
| 413584 | Other | VA | MHN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904003048 (Virginia) | Primary |
| Provider Name | Susan Cummings Nicholson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023232626 PECOS PAC ID: 3173510021 Enrollment ID: I20040430001112 |
| Provider Name | Baljit Singh Gill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356303366 PECOS PAC ID: 7810097896 Enrollment ID: I20070703000675 |
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