Ethan Nicholas, LCSW, LAC, LMSW in Fort Polk, LA - Social Worker

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.

Contact Information

	Ethan Nicholas, LCSW, LAC, LMSW
	1585 3rd St, Fort Polk, LA 71459-5102
	(337) 531-3942
	Not Available

Healthcare Provider's Profile

Full Name	Ethan Nicholas
Gender	Male
Speciality	Social Worker - Clinical
Location	1585 3rd St, Fort Polk, Louisiana
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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Ethan Nicholas, LCSW, LAC, LMSW - Counselor in Fort Polk, LA