Demetrious Tra Nicholson

Counselor · Charlottesville, VA

Individual Active NPI

NPI number 1558175620

Practice location

141 Ednam Dr Ste 104
Charlottesville, VA 22903-4629
Phone
(434) 202-4080

Open in Google Maps

NPI record

NPI
1558175620
Entity type
Individual (Type 1)
Enumeration date
February 6, 2025
Last updated
February 6, 2025
Certified
February 6, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Counselor Primary 101Y00000X 0704017770 VA

Mailing address

4927 Sheridan St
Charlottesville, VA 22902-9026
Phone
(757) 737-9216

About Demetrious Nicholson

Demetrious Tra Nicholson is a healthcare provider registered in the NPI registry with the primary taxonomy Counselor (code 101Y00000X). The practice location is 141 Ednam Dr Ste 104, Charlottesville, VA 22903-4629. The NPI number 1558175620 was assigned on February 6, 2025 and the record was last updated on February 6, 2025.

Demetrious Nicholson lists a license in the registry: #0704017770 (VA) for Counselor. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Demetrious Tra Nicholson?

The NPI number is 1558175620.

What is the phone number of Demetrious Nicholson?

The phone number listed for the practice location is (434) 202-4080.

Where is Demetrious Nicholson located?

141 Ednam Dr Ste 104, Charlottesville, VA 22903-4629.

What is the taxonomy code for Demetrious Nicholson?

The primary taxonomy code is 101Y00000X – Counselor.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other Counselor providers in Charlottesville

All Counselor providers in Charlottesville, VA →