Basic Information
Provider Information
NPI: 1730714957
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIGLIN
FirstName: NICOLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.ED, LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4653 E MAIN ST
Address2:  
City: WHITEHALL
State: OH
PostalCode: 432133298
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4653 E MAIN ST
Address2:  
City: WHITEHALL
State: OH
PostalCode: 432133298
CountryCode: US
TelephoneNumber: 6148752371
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/09/2020
LastUpdateDate: 06/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  N Behavioral Health & Social Service ProvidersCounselor 
101YM0800XC.2103223OHY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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