NPI 1417792623

Michael Nickson, VRCCRCLCPC

Practitioner Rehabilitation Counselor Hines, IL

Practice location

Address: Edward Hines Jr. VA Hospital, Vrs(mc:116a7) 5000 S. 5th Ave., Hines, IL 60141
Phone: (708) 202-2530
Mailing address: 6930 S Honore St, Chicago, IL 60636-3234

Registered specialties (3)

Rehabilitation Counselor Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225C00000X Licence 65571

Other Rehabilitation Counselor providers in Illinois →

Mental Health Counselor

Behavioral Health & Social Service Providers Taxonomy 101YM0800X Licence 180.007568 (IL)

Other Counselor providers in Illinois →

Professional Counselor

Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence 180.007568 (IL)

Registry record

NPI: 1417792623
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Jun 2024
Record last updated: 28 Jun 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.