Provider Demographics
NPI:1205665791
Name:NOLAN PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:NOLAN PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER / CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:BLASI
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LLP/LPC
Authorized Official - Phone:517-881-3446
Mailing Address - Street 1:3503 GREENLEAF BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-2580
Mailing Address - Country:US
Mailing Address - Phone:517-881-3446
Mailing Address - Fax:
Practice Address - Street 1:3503 GREENLEAF BLVD STE 201
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-2580
Practice Address - Country:US
Practice Address - Phone:517-881-3446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)