Wilbert Sinclair Nicholson Jr., CSCA
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Jackson, NC
NPI 1699148205 · NPPES record last updated Nov 4, 2015
Key facts
- NPI
- 1699148205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CSAC-22055 (NC)
- Practice address
- 10174 NC Highway 305
Jackson, NC 27845-9685 - Phone
- (919) 384-6033
- NPI assigned
- Nov 4, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSAC-22055 | NC | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CSAC-22055 | NC | Yes |
Addresses
Primary practice location
10174 NC Highway 305
Jackson, NC 27845-9685
Mailing address
10174 NC Highway 305
Jackson, NC 27845-9685
Phone (919) 384-6033
Other providers in Jackson, NC
- Kindred Healthcare
- Kindred Healthcare
- Kindred Healthcare
- Franklin Alexander Measamer Jr.
- Mary Kate Morris
- Northampton County
- Northampton County
- Northampton County
- Northampton County DSS
- Northampton County School
All providers in Jackson, NC · Addiction (Substance Use Disorder) Counselor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.