Provider Demographics
NPI:1497152300
Name:TUCHOLSKI, NICHOLAS ALAN (MSW, LISW-S)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:ALAN
Last Name:TUCHOLSKI
Suffix:
Gender:M
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1946 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-7258
Mailing Address - Country:US
Mailing Address - Phone:419-214-3820
Mailing Address - Fax:
Practice Address - Street 1:1946 N 13TH ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-7258
Practice Address - Country:US
Practice Address - Phone:419-214-3820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1201056104100000X
OHI.15000711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker