| Doctor Name: | DR. SUSAN CUMMINGS NICHOLSON |
| NPI Number: | 1023232626 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD, LCSW, BCD |
| License Number: | 0904003048 |
| Business Practice Address: | 703 Thimble Shoals Blvd A-3 Newport News, VA - 236062576 |
| Business Phone Number: | 7578733401 |
| Business Fax Number: | 7572231165 |
| Mailing Address: | 203 Woodburne Ln, NEWPORT NEWS |
| State: | VA |
| Postal Code: | 236028363 |
| Phone Number: | 7578692361 |
| Fax Number: | 7572231165 |
| NPI Enumeration Date: | 04/13/2007 |
| NPI Last Update Date: | 02/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 0904003048 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |