Provider Demographics
NPI:1992493787
Name:HORTON, NICHALAUS (PLMSW)
Entity type:Individual
Prefix:MR
First Name:NICHALAUS
Middle Name:
Last Name:HORTON
Suffix:
Gender:M
Credentials:PLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 S ARCH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72206-6529
Mailing Address - Country:US
Mailing Address - Phone:501-551-1201
Mailing Address - Fax:501-615-8721
Practice Address - Street 1:2718 S ARCH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72206-6529
Practice Address - Country:US
Practice Address - Phone:501-551-1201
Practice Address - Fax:501-615-8721
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPLMSW104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker