Basic Information
| Provider Information | |||||||||
| NPI: | 1962944678 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KLIMAS-MORRISON | ||||||||
| FirstName: | NICOLE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | LISW-S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 202 E BAGLEY RD | ||||||||
| Address2: | |||||||||
| City: | BEREA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440172058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402608327 | ||||||||
| FaxNumber: | 4402348319 | ||||||||
| Practice Location | |||||||||
| Address1: | 2173 N RIDGE RD E | ||||||||
| Address2: | SUITE E | ||||||||
| City: | LORAIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440553400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402606108 | ||||||||
| FaxNumber: | 4402823400 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2016 | ||||||||
| LastUpdateDate: | 12/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | I1901964 | OH | N | Behavioral Health & Social Service Providers | Social Worker | 104100000X | S.1200643 | OH | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | I1901964 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.