Nicole Bolduc, MSW, LISW-S, LICDC,
Social Worker, Clinical in Maumee, OH. Individual provider (NPI-1).
NPI number1831556547
StatusActive
Last updated in NPPESDec 26, 2024
Details
- NPI
- 1831556547
- Entity type
- Individual (NPI-1)
- Name
- Nicole Bolduc
- Credential
- MSW, LISW-S, LICDC,
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 26, 2016
- Certification date
- Dec 26, 2024
- Last updated
- Dec 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | I.1901415 | OH | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | LICDC.161857 | OH | |
| 101YM0800X | Counselor, Mental Health | 34008910A | IN | |
| 101YM0800X | Counselor, Mental Health | 2394 | NH | |
| 104100000X | Social Worker | S.1502497 | OH | |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
1331 Conant St Ste 201Maumee, OH 43537-4214
Phone 419-665-1277
Mailing address
1331 Conant St Ste 201Maumee, OH 43537-4214
Phone 419-217-0674
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