Provider Demographics
NPI:1699584227
Name:NICHOLS, JOAN ELIZAVETH (LPC-MHSP(T))
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:ELIZAVETH
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:LPC-MHSP(T)
Other - Prefix:MRS
Other - First Name:LIZZIE
Other - Middle Name:
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2040 EMORILAND BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-2225
Mailing Address - Country:US
Mailing Address - Phone:601-209-2466
Mailing Address - Fax:
Practice Address - Street 1:2911 ESSARY DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-2468
Practice Address - Country:US
Practice Address - Phone:865-839-6108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6172101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health