Provider Demographics
NPI:1588905772
Name:PAPPAS, NICHOLAS (PHD, LPC)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:PAPPAS
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14621 NEW MILLPOND RD
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-8968
Mailing Address - Country:US
Mailing Address - Phone:231-796-3312
Mailing Address - Fax:231-796-3312
Practice Address - Street 1:14621 NEW MILLPOND RD
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-8968
Practice Address - Country:US
Practice Address - Phone:231-676-4067
Practice Address - Fax:231-796-3312
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013520101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health