Nicole L Logan

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

176200 Issued in OH

Practice address

3214 Prospect Ave E
Cleveland, OH 44115-2614

Phone

(216) 910-9015

Fax

(216) 910-9015

NPI assigned

May 20, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1235704552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34474 SCOTCH LN APT 4",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440942991",
            "telephone_number": "770-369-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3214 PROSPECT AVE E",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152614",
            "telephone_number": "216-910-9015",
            "fax_number": "216-910-9015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25201 Chagrin Blvd Ste 390",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "441225637",
            "country_code": "US",
            "telephone_number": "216-910-9015",
            "fax_number": "216-910-9015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "NICOLE",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "176200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angeli Y Logan-Horhn, LPN
• Amelia Logan, QMHSBA, CMS
• Gwendolyn Logan
• Leslie Marie Logan, CNM
• Margaret Rachelle Logan
• Paul Logan, P.T.
• Oksana Loginova
• Elizabeth Grace Lohan, OTR/L
• Theresa Lohn, PA-C
• Melissa E Lohr, CNP

• Addiction (Substance Use Disorder) Counselor in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.