MEDICARE: NICKOLE BOLLINI LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	C.2002630	OH
2	101Y00000X	Counselor		OH
3	101YP2500X	Professional Counselor	E.2504997	OH

General Provider Information

NPI Number	:	1962062513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICKOLE BOLLINI LPCC

Provider Business Mailing Address
First Line	:	521 5TH AVE STE A
Second Line	:
City	:	CHARDON
State	:	OH
Zip	:	44024-1088
Country	:	US
Telephone Number	:	440-286-1553
Fax Number	:

Provider Business Practice Location Address
First Line	:	521 5TH AVE STE A
Second Line	:
City	:	CHARDON
State	:	OH
Zip	:	44024-1088
Country	:	US
Telephone Number	:	440-286-1553
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2019
Last Update Date	:	05/20/2025

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Directions to “ NICKOLE BOLLINI LPCC” Practice Location

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