Provider Demographics
NPI:1316463789
Name:STEVEN D NICHOLS PHD LLC
Entity type:Organization
Organization Name:STEVEN D NICHOLS PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:513-312-2203
Mailing Address - Street 1:3200 LINWOOD AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-1274
Mailing Address - Country:US
Mailing Address - Phone:513-312-2203
Mailing Address - Fax:513-672-9277
Practice Address - Street 1:3200 LINWOOD AVE STE 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45226-1274
Practice Address - Country:US
Practice Address - Phone:513-312-2203
Practice Address - Fax:513-672-9277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty