Individual
CAROLYN NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW,MSW
Contact information
Practice address
1834 E 55TH STREET, CLEVELAND, OH 44103
(216) 202-1017
Mailing address
1834 E 55TH ST, CLEVELAND, OH 44103-3602
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
S1501342
OH
Other
Enumeration date
08/21/2017
Last updated
08/21/2017
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