Black, Nickolas

Black, Nickolas is an individual health care provider with primary practice located at 1022 Main St , Conway AR 72032-5426. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Black, Nickolas can be contacted via phone (501) 609-0400.

Contact Information

Primary practice address
1022 Main St Conway AR 72032-5426
Phone: (501) 609-0400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Professional 101YP2500X P2108000 Arkansas

Profile Details

NPI number 1801345921
LBN Legal business name Black, Nickolas
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2016
Last updated Oct 4th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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