Healthcare Provider Details

I. General information

NPI: 1639717259
Provider Name (Legal Business Name): NICHOLE MARIE FINCH LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NIKKI FINCH LMSW

II. Dates (important events)

Enumeration Date: 12/13/2019
Last Update Date: 12/13/2019
Certification Date: 12/13/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 PERE MARQUETTE DR STE 2D
LANSING MI
48912-1270
US

IV. Provider business mailing address

138 ALLEN ST
LANSING MI
48912-2707
US

V. Phone/Fax

Practice location:
  • Phone: 517-881-8774
  • Fax:
Mailing address:
  • Phone: 517-881-8774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801097620
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: