Provider Demographics
NPI:1265924450
Name:BIALOWICZ, NICOLE ASHLEY (LMSW, CADC)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:ASHLEY
Last Name:BIALOWICZ
Suffix:
Gender:F
Credentials:LMSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9823 BIRCH RUN
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-8951
Mailing Address - Country:US
Mailing Address - Phone:810-923-2030
Mailing Address - Fax:
Practice Address - Street 1:2895 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8538
Practice Address - Country:US
Practice Address - Phone:517-548-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011025931041C0700X
MI68011077051041C0700X
MI2-01324101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)