MRS. JEAN MARIE NICHOLS
NPI 1780041210
Counselor - Addiction (Substance Use Disorder) in Coos Bay, OR
Active since January 28, 2016
About Mrs. Jean Marie Nichols NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. JEAN MARIE NICHOLS (NPI 1780041210) is an individual addiction (substance use disorder) provider in Coos Bay, Oregon and active in the NPI registry since January 2016.
NPPES Registry Identity
NPI1780041210
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMRS. JEAN MARIE NICHOLS
Location Address2650 KOOS BAY BLVDCoos Bay, OR 97420-2579
Mailing Address1610 Johnson StNorth Bend, OR 97459-1936 · (541) 217-1514
Phone(541) 294-7001
Sole ProprietorNo
Enumeration DateJanuary 28, 2016
Last NPPES UpdateJune 22, 20232 updates tracked since enumeration
NPPES CertifiedJune 22, 2023
✔ NPI 1780041210 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 4
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
Also ListedPeer SpecialistTaxonomy 175T00000X · License 23-CRM-II-0086 (OR)
2650 KOOS BAY BLVD, Coos Bay, OR 97420
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1780041210, enumerated as an "individual" on January 28, 2016.
The provider is located at 2650 KOOS BAY BLVD COOS BAY, OR 97420 and the phone number is (541) 294-7001.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
