Ethan Nicholas, LCSW, LAC, LMSW is a
Social Worker - Clinical based in Fort Polk, Louisiana. Ethan Nicholas is licensed to practice in Louisiana (license number 12901) and his current practice location is
1585 3rd St, Fort Polk, Louisiana. He can be reached at his office (for appointments etc.) via phone at
(337) 531-3942.
NPI number for Ethan Nicholas is 1518350222 and his current mailing address is 5593 Highway 311, Houma, Louisiana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1518350222.
Healthcare Provider's Profile
Full Name | Ethan Nicholas |
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Gender | Male |
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Speciality | Social Worker - Clinical |
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Location | 1585 3rd St, Fort Polk, Louisiana |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1518350222
- Provider Enumeration Date: 03/05/2015
- Last Update Date: 06/30/2020
Medical Identifiers
Medical identifiers for Ethan Nicholas such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1518350222 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 1548 (Louisiana) | Secondary |
104100000X | Social Worker | 12901 (Louisiana) | Secondary |
1041C0700X | Social Worker - Clinical | 12901 (Louisiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Nicholas is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ethan Nicholas, LCSW, LAC, LMSW 5593 Highway 311, Houma, LA 70360-2866 Ph: (985) 868-2620 | Ethan Nicholas, LCSW, LAC, LMSW 1585 3rd St, Fort Polk, LA 71459-5102 Ph: (337) 531-3942 |
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