Provider Demographics
NPI:1922507094
Name:MCLACHLAN, NICHOLE LYNE (MPA, LBSW)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:LYNE
Last Name:MCLACHLAN
Suffix:
Gender:F
Credentials:MPA, LBSW
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:LYNE
Other - Last Name:MCLACHLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3258 RINGLE RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:MI
Mailing Address - Zip Code:48701-9519
Mailing Address - Country:US
Mailing Address - Phone:989-737-4840
Mailing Address - Fax:
Practice Address - Street 1:3258 RINGLE RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:MI
Practice Address - Zip Code:48701-9519
Practice Address - Country:US
Practice Address - Phone:989-737-4840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68020876651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical