Provider Demographics
NPI:1790585412
Name:NOLEN, SEAN (CADC, MA,)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:
Last Name:NOLEN
Suffix:
Gender:
Credentials:CADC, MA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 S PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-6280
Mailing Address - Country:US
Mailing Address - Phone:630-673-5726
Mailing Address - Fax:
Practice Address - Street 1:1116 BRIERGATE DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2206
Practice Address - Country:US
Practice Address - Phone:708-769-1509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health