William Charles Nichols, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

00-12P Issued in AR

Practice address

623 N Walnut St
Harrison, AR 72601-3617

Phone

(870) 743-6225

Fax

(870) 743-6006

NPI assigned

Apr 27, 2006

Last updated

Jan 3, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Psychological Center

  • Clinical Psychologist
  • Harrison, AR
  • NPI 1033293733
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1215994876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 N WALNUT ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726013617",
            "telephone_number": "870-743-6225",
            "fax_number": "870-743-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 N WALNUT ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726013617",
            "telephone_number": "870-743-6225",
            "fax_number": "870-743-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "WILLIAM",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "00-12P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141383019",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148984744",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC B S GROUP",
            "identifier": "5C757",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "5W126",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mandy Nash, ATC
• Peter Neckles, MHPP
• Nes Arkansas, Inc.
• New Hope Counseling Inc
• Shelby Kait Nichols
• Ashley Nordin, MS, LAT/ATC
• Eva Laynette Norris
• North Arkansas Counseling Foundation
• North Arkansas Ear Nose and Throat PA
• North Arkansas Regional Medical Center (NARMC General and Specialty Surgery)

• Clinical Psychologist in Harrison, AR
• Providers in Harrison, AR by specialty
• Clinical Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.