Provider Demographics
NPI:1518049287
Name:NOLAN, TONYA L (LSW)
Entity Type:Individual
Prefix:MS
First Name:TONYA
Middle Name:L
Last Name:NOLAN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11580 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-7460
Mailing Address - Country:US
Mailing Address - Phone:216-533-5653
Mailing Address - Fax:
Practice Address - Street 1:3076A REMSEN RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-9225
Practice Address - Country:US
Practice Address - Phone:330-722-0750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS. 00290451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical