Provider Demographics
NPI:1285731935
Name:PAPPAS, LCSW, LLC, NICHOLAS J (LCSW)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:J
Last Name:PAPPAS, LCSW, LLC
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:NICHOLAS
Other - Middle Name:J
Other - Last Name:PAPPAS, MSW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 1731
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36533-1731
Mailing Address - Country:US
Mailing Address - Phone:251-454-6108
Mailing Address - Fax:251-626-2897
Practice Address - Street 1:900 WESTERN AMERICA CIR
Practice Address - Street 2:STE 211
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609
Practice Address - Country:US
Practice Address - Phone:251-454-6108
Practice Address - Fax:251-626-2897
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0144C101YM0800X
AL95-PIP-0144C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPIP-95-0144COtherPIP LICENSE
51034771OtherBLUE CROSS
AL34771Medicare ID - Type Unspecified
51034771OtherBLUE CROSS