Healthcare Provider Details

I. General information

NPI: 1023945441
Provider Name (Legal Business Name): JODIE LYNN NICHOLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JODIE LYNN SAUER

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 STREETS RUN RD
PITTSBURGH PA
15236-2023
US

IV. Provider business mailing address

103 FRONTENAC RD
NEW KENSINGTON PA
15068-9371
US

V. Phone/Fax

Practice location:
  • Phone: 412-267-7211
  • Fax:
Mailing address:
  • Phone: 715-222-0338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: