JAE NICHOLSON
NPI 1619620176
Counselor - Professional in Bryan, TX

Active since February 03, 2022
2490 BOONVILLE RD, BRYAN, TX 77808(979) 703-1808 Get Directions Write a Review

NPPES record last updated: February 3, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jae Nicholson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAE NICHOLSON (NPI 1619620176) is an individual professional provider in Bryan, Texas, licensed in (76655) and active in the NPI registry since February 2022.

NPPES Registry Identity

NPI1619620176
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJAE NICHOLSON
Location Address2490 BOONVILLE RDBryan, TX 77808-2326
Mailing Address2490 Boonville RdBryan, TX 77808-2326
Sole ProprietorYes
Enumeration DateFebruary 3, 2022
NPPES CertifiedFebruary 3, 2022
NPI 1619620176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed · 76655
2490 BOONVILLE RD, Bryan, TX 77808

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
2490 BOONVILLE RD
BRYAN, TX 77808
Social Worker (Clinical)
2490 BOONVILLE RD
BRYAN, TX 77808
Counselor (Professional)
2490 BOONVILLE RD
BRYAN, TX 77808
Counselor (Professional)
2490 BOONVILLE RD
BRYAN, TX 77808
Marriage & Family Therapist
2490 BOONVILLE RD
BRYAN, TX 77808
Counselor (Mental Health)
2490 BOONVILLE RD
BRYAN, TX 77808
Counselor (Professional)
2490 BOONVILLE RD
BRYAN, TX 77808
Psychologist (School)
2490 BOONVILLE RD
BRYAN, TX 77808

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jae Nicholson's NPI number?

The NPI number for Jae Nicholson is 1619620176. It was assigned to this individual provider in the NPPES registry on February 3, 2022.

Where is Jae Nicholson located?

Jae Nicholson practices at 2490 Boonville Rd, Bryan, TX 77808. The listed phone number is (979) 703-1808.

What is Jae Nicholson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Jae Nicholson was last updated on February 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.