Provider Demographics
NPI:1326269556
Name:MARICH, JAMIE NICOLE (PHD, LPCC-S, LICDC)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:NICOLE
Last Name:MARICH
Suffix:
Gender:F
Credentials:PHD, LPCC-S, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1377 SPRINGWOOD TRCE SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-3100
Mailing Address - Country:US
Mailing Address - Phone:330-881-2944
Mailing Address - Fax:330-349-4274
Practice Address - Street 1:1377 SPRINGWOOD TRCE SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-3100
Practice Address - Country:US
Practice Address - Phone:330-881-2944
Practice Address - Fax:330-349-4274
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH061001101YA0400X
OHC.0500149.CR101YP2500X
OHE.0500149.SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional