Provider Demographics
NPI:1851691620
Name:DINGWELL FRENDT, NICOLE CHERI (MSW)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:CHERI
Last Name:DINGWELL FRENDT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:CHERI
Other - Last Name:DINGWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW CAADC CSATS CCS
Mailing Address - Street 1:1801 E SAGINAW ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-2326
Mailing Address - Country:US
Mailing Address - Phone:517-599-1247
Mailing Address - Fax:888-975-3255
Practice Address - Street 1:1801 E SAGINAW ST STE 1
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-2326
Practice Address - Country:US
Practice Address - Phone:517-599-1247
Practice Address - Fax:888-975-3255
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010925641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801092564OtherSTATE OF MI