Provider Demographics
NPI:1588146328
Name:NICHOLSON, MARGARET ANN (LICSW)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ANN
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:294 BOWDOIN ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-1814
Mailing Address - Country:US
Mailing Address - Phone:857-220-2333
Mailing Address - Fax:617-506-7695
Practice Address - Street 1:294 BOWDOIN ST
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122-1814
Practice Address - Country:US
Practice Address - Phone:857-220-2333
Practice Address - Fax:617-506-7695
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW10194801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical