Provider Demographics
NPI:1184433583
Name:SARGENT, NICCOLE RENEE
Entity type:Individual
Prefix:
First Name:NICCOLE
Middle Name:RENEE
Last Name:SARGENT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NICCOLE
Other - Middle Name:RENEE
Other - Last Name:HAUGHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2423 S HOLLAND SYLVANIA RD APT 299
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1458
Mailing Address - Country:US
Mailing Address - Phone:567-801-5457
Mailing Address - Fax:
Practice Address - Street 1:3000 REGENCY CT STE 207
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3081
Practice Address - Country:US
Practice Address - Phone:567-389-0288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-01
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health