Nicholson Psychophysiological Rehab

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0857 Issued in AZ

Legal business name

NICHOLSON PSYCHOPHYSIOLOGICAL REHAB

Practice address

5956 E Pima St
Suite 130
Tucson, AZ 85712

Phone

(520) 722-2892

Fax

(520) 722-2873

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Elaine Ruthe Nicholson, PHD

Title

Owner

Phone

(520) 722-2892

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1942331368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30755",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857510755",
            "telephone_number": "520-722-2892",
            "fax_number": "520-722-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5956 E PIMA ST",
            "address_2": "SUITE 130",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85712",
            "telephone_number": "520-722-2892",
            "fax_number": "520-722-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLSON PSYCHOPHYSIOLOGICAL REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "RUTHE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-722-2892",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "0857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen P Nichols, MD
• Linnea Nichols
• Mark A Nichols, MD
• Mark Alan Nichols, M.ED., MAC, NCC, LPC
• Reggie Allen Nichols, PA-C
• Brooke Nicholson, PHARMD
• Deborah Nicholson, PHARMD
• Douglas Nicholson
• Maria Nicholson
• Lorrie L Nickel, RN

• Psychologist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.