Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jackson Tate Nichols

Individual provider Clinical Social Worker · NPI 1548130255

Mr. Jackson Tate Nichols is a Clinical Social Worker in Sheridan, Wyoming. Practices as a sole proprietor. Licensed in Wyoming.

Licensed in
WY
In the registry since
2025
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Practice location Address checks out

101 E Loucks St # 3014
Sheridan, WY 82801-9998
Phone: (307) 752-3463
Fax: (307) 752-3463
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence PCSW-1274 (WY)

Record details

NPI number1548130255
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 7, 2025
Last updated in NPPESNovember 7, 2025
Certification dateNovember 6, 2025

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