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

MR. JACKSON TATE NICHOLS

Active Sole Proprietor

Clinical Social Worker · SHERIDAN, WY

Registration Details

NPI Number
1548130255
Provider Type
Individual
Gender
Male
NPI Issued
Nov 7, 2025 (0.46499296212322 yrs)
Last Updated
Nov 7, 2025
License
PCSW-1274 (WY)
Sole Proprietor
Yes

Practice Information

Address
101 E LOUCKS ST # 3014
SHERIDAN, WY, 828019998
Browse WY providers · Browse ZIP 82801
Phone
3077523463
Fax
3077523463
Primary Specialty
Clinical Social Worker
1041C0700X

Other Clinical Social Worker Providers in SHERIDAN, WY

Name Credential NPI
BECKY SUE CLARK LCSW 1306806955
MILTON MEIS MSW 1922056027
PATRICIA L SCHWAIGER MSW 1174571590
MRS. DONNA JEAN HOLST MSW, LCSW, LAT 1801845805
SHARYN SILER LCSW 1376597245
MR. JASON CAINE CARTER LCSW 1659325553
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.