Provider Demographics
NPI:1205600152
Name:HADLEY, NICHOLAS EMMETT (LMSW)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:EMMETT
Last Name:HADLEY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 N POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE CLOUD
Mailing Address - State:MI
Mailing Address - Zip Code:49349-9626
Mailing Address - Country:US
Mailing Address - Phone:616-312-8949
Mailing Address - Fax:
Practice Address - Street 1:130 W WOOD ST
Practice Address - Street 2:
Practice Address - City:NEWAYGO
Practice Address - State:MI
Practice Address - Zip Code:49337-8991
Practice Address - Country:US
Practice Address - Phone:231-498-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011169331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical