Provider Demographics
NPI:1881138709
Name:FRIE, NICOLE LYNN (MSW LICSW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:LYNN
Last Name:FRIE
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:POHLMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:425 ELM ST N
Mailing Address - Street 2:
Mailing Address - City:SAUK CENTRE
Mailing Address - State:MN
Mailing Address - Zip Code:56378-1010
Mailing Address - Country:US
Mailing Address - Phone:320-351-1762
Mailing Address - Fax:320-351-1739
Practice Address - Street 1:425 ELM ST N
Practice Address - Street 2:
Practice Address - City:SAUK CENTRE
Practice Address - State:MN
Practice Address - Zip Code:56378-1010
Practice Address - Country:US
Practice Address - Phone:320-351-1762
Practice Address - Fax:320-351-1739
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN205811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical