Healthcare Provider Details

I. General information

NPI: 1801313614
Provider Name (Legal Business Name): NICHOLAS FEUCHT LLBSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 E SANILAC RD
SANDUSKY MI
48471-1160
US

IV. Provider business mailing address

227 E SANILAC RD
SANDUSKY MI
48471-1160
US

V. Phone/Fax

Practice location:
  • Phone: 810-648-0330
  • Fax:
Mailing address:
  • Phone: 810-648-0330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6802091091
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: