Provider Demographics
NPI:1073075362
Name:NICHOL, CORRINE (PSYD)
Entity Type:Individual
Prefix:
First Name:CORRINE
Middle Name:
Last Name:NICHOL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CORRINE
Other - Middle Name:
Other - Last Name:BABIKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:809 BALMORAL CT
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-4269
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:615 WASHINGTON RD STE 500
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1926
Practice Address - Country:US
Practice Address - Phone:412-343-6416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018765103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty