DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. JASEN RALPH NICHOLS, M.A.

Active

MR. JASEN RALPH NICHOLS, M.A. is a Clinical Psychologist healthcare provider located in ELIZABETH, West Virginia. NPI 1528332921 is currently active in the NPPES registry. Verify at CMS.

Clinical Psychologist · ELIZABETH, WV

Registration Details

NPI Number
1528332921
Provider Type
Individual
Gender
Male
NPI Issued
Mar 2, 2012 (14.440832874012 yrs)
Last Updated
Feb 17, 2017
License
1011 (WV)

Practice Information

Address
483 COURT STREET
ELIZABETH, WV, 261430609
Browse WV providers · Browse ZIP 26143
Phone
3042753301
Fax
3042754798
Primary Specialty
Clinical Psychologist
103TC0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.