| Doctor Name: | LISA NICHOLS |
| NPI Number: | 1699822734 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 016302-1 |
| Business Practice Address: | 1545 Atlantic Avenue Brooklyn, NY - 11213 |
| Business Phone Number: | 7186136618 |
| Business Fax Number: | |
| Mailing Address: | 414 E 88th St Apt 1a, NEW YORK |
| State: | NY |
| Postal Code: | 101286684 |
| Phone Number: | 9172578481 |
| Fax Number: | |
| NPI Enumeration Date: | 01/04/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 283Q00000X |
| License Number: | 016302-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Psychiatric Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |