Provider Demographics
NPI:1669850202
Name:NIDY, BRITTANY MARIE (LISW-S)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:NIDY
Suffix:
Gender:F
Credentials: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:PO BOX 290
Mailing Address - Street 2:
Mailing Address - City:UHRICHSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44683-0290
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:117 E 3RD ST
Practice Address - Street 2:
Practice Address - City:UHRICHSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44683-1818
Practice Address - Country:US
Practice Address - Phone:740-922-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-15
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1500476104100000X
OHI.1700624-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker