Provider Demographics
NPI:1275688913
Name:BING NIESET, CAROLYN (LISW)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:BING NIESET
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 CROGHAN ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420
Mailing Address - Country:US
Mailing Address - Phone:419-680-6005
Mailing Address - Fax:419-334-8021
Practice Address - Street 1:428 CROGHAN ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420
Practice Address - Country:US
Practice Address - Phone:419-680-6005
Practice Address - Fax:419-334-8021
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS-00179971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical