Nicole Alexandria Miracle, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

186560 Issued in OH

Practice address

1087 W 2ND St
Xenia, OH 45385-3713

Phone

(937) 708-8053

NPI assigned

Jan 17, 2024

Last updated

Jan 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baymark Health Services of Ohio, Inc.

  dba MedMark Treatment Centers Lebanon

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lebanon, OH
  • NPI 1740847557
  NPD (past)
• Emerge Recovery and Trades Initiative

  • Community/Behavioral Health Agency
  • Xenia, OH
  • NPI 1205544426
  NPD (past)

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1275394371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 E HELENA ST APT G",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054210",
            "telephone_number": "937-794-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1087 W 2ND ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453853713",
            "telephone_number": "937-708-8053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 N Main St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454051624",
            "country_code": "US",
            "telephone_number": "937-203-2017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRACLE",
        "first_name": "NICOLE",
        "middle_name": "ALEXANDRIA",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "186560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindy Miller
• Rachel Miller
• Timothy Miller, RN
• Cherie Mills
• Emily Katherine Minehart
• Jillyan Misiak
• Angie M Mitchell, CDCA
• Emily Louise Mitchell, M.A.
• Mobility Fit Physical Therapy LLC
• Amanda Mobley

• Addiction (Substance Use Disorder) Counselor in Xenia, OH
• Providers in Xenia, 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 Jan 17, 2024; 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.