Healthcare Provider Details

I. General information

NPI: 1578299905
Provider Name (Legal Business Name): NATASHA NICHOLS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32886 BAINBRIDGE RD
SOLON OH
44139-2264
US

IV. Provider business mailing address

34194 AURORA RD # 184
SOLON OH
44139-3801
US

V. Phone/Fax

Practice location:
  • Phone: 440-732-3989
  • Fax:
Mailing address:
  • Phone: 440-732-3989
  • Fax: 440-571-6872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: NATASHA NICHOLS
Title or Position: OWNER / THERAPIST
Credential: LPCC-S, BC-TMH
Phone: 440-732-3989