Healthcare Provider Details

I. General information

NPI: 1912591926
Provider Name (Legal Business Name): BRIANNA M NOLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

238 S MERIDIAN RD
YOUNGSTOWN OH
44509-2925
US

IV. Provider business mailing address

238 S MERIDIAN RD
YOUNGSTOWN OH
44509-2925
US

V. Phone/Fax

Practice location:
  • Phone: 330-318-3436
  • Fax:
Mailing address:
  • Phone: 330-318-3436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: