Provider Demographics
NPI:1942473376
Name:SAULINO, NIKKI (MED, LSW, PC, NCC)
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:
Last Name:SAULINO
Suffix:
Gender:F
Credentials:MED, LSW, PC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 VICTORIA PL
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-3466
Mailing Address - Country:US
Mailing Address - Phone:440-352-8954
Mailing Address - Fax:440-352-0351
Practice Address - Street 1:1 VICTORIA PL
Practice Address - Street 2:SUITE 105
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-3466
Practice Address - Country:US
Practice Address - Phone:440-352-8954
Practice Address - Fax:440-352-0351
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS-0007852101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2314490Medicaid