Provider Demographics
NPI:1154867463
Name:OCHAL, NICHOLAS (LLMSW)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:OCHAL
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32715 DORSEY ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-4755
Mailing Address - Country:US
Mailing Address - Phone:734-641-1141
Mailing Address - Fax:
Practice Address - Street 1:32715 DORSEY ST
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-4755
Practice Address - Country:US
Practice Address - Phone:734-641-1141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801100365101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)