Provider Demographics
NPI:1952929457
Name:SALISBURY, NICOLE (LMSW)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 PACKARD ST STE 220
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2366
Mailing Address - Country:US
Mailing Address - Phone:248-919-8653
Mailing Address - Fax:855-610-2294
Practice Address - Street 1:3810 PACKARD ST STE 220
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2366
Practice Address - Country:US
Practice Address - Phone:248-919-8653
Practice Address - Fax:855-610-2294
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011075141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical