Provider Demographics
NPI:1164620225
Name:HOLUB, NICHOLAS (PSYD, MSW)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:HOLUB
Suffix:
Gender:M
Credentials:PSYD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 OFFICE PARK WAY STE 1
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1734
Mailing Address - Country:US
Mailing Address - Phone:585-673-2002
Mailing Address - Fax:585-203-1927
Practice Address - Street 1:30 OFFICE PARK WAY STE 1
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-1734
Practice Address - Country:US
Practice Address - Phone:585-673-2002
Practice Address - Fax:585-203-1927
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2025-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025522103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty