Healthcare Provider Details

I. General information

NPI: 1114411733
Provider Name (Legal Business Name): NICOLE ANN HOLLINGSHEAD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W MAIN ST FL 2
NEW ALBANY OH
43054-9229
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-9600
  • Fax: 614-366-1215
Mailing address:
  • Phone: 614-293-9600
  • Fax: 614-366-1215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP.07734
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: