Small, Nicole Reynolds

Small, Nicole Reynolds is an sole proprietor health care provider with primary practice located at 1005 S 3Rd St , Mount Vernon WA 98273-4301. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Small, Nicole Reynolds can be contacted via phone (360) 419-3612.

Contact Information

Primary practice address
1005 S 3Rd St Mount Vernon WA 98273-4301
Phone: (360) 419-3612
Fax: (360) 419-3605
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X ASW18384 California
Behavioral Health & Social Service Providers / School 1041S0200X PPSC #060034254 California
Behavioral Health & Social Service Providers / Counselor 101Y00000X RC00058160 Washington
Behavioral Health & Social Service Providers / School 1041S0200X 443673R Washington
Behavioral Health & Social Service Providers / Clinical 1041C0700X LW 60064972 Washington

Profile Details

NPI number 1417072356
LBN Legal business name Small, Nicole Reynolds
Credentials MSW, LICSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 20th, 2007
Last updated Jan 20th, 2010 - about 16 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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Identifiers

StateTypeNumberIssuer
All States NPI 1417072356 NPPES
California Other PSIX593 DMH

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