Provider Demographics
NPI:1215483805
Name:SCHRAM, NICOLE RYAN (LPC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:RYAN
Last Name:SCHRAM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 W WACKERLY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2795
Mailing Address - Country:US
Mailing Address - Phone:989-272-3812
Mailing Address - Fax:989-203-5525
Practice Address - Street 1:214 W WACKERLY ST STE 200
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2795
Practice Address - Country:US
Practice Address - Phone:989-832-2165
Practice Address - Fax:989-839-4376
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015516101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor