Healthcare Provider Details

I. General information

NPI: 1801823257
Provider Name (Legal Business Name): NICOLE EHART MA, LLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 PLYMOUTH RD STE 126
PLYMOUTH MI
48170-4080
US

IV. Provider business mailing address

409 PLYMOUTH RD STE 126
PLYMOUTH MI
48170-4080
US

V. Phone/Fax

Practice location:
  • Phone: 248-837-0303
  • Fax:
Mailing address:
  • Phone: 248-837-0303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6361000909
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: