Chad Nickell

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.176504 Issued in OH

Practice address

2317 E Home Rd
Springfield, OH 45503-2520

Phone

(937) 390-8060

NPI assigned

Jul 26, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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 and National Provider Directory roles.

• 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": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1346913498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 E HOME RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032520",
            "telephone_number": "937-250-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 E HOME RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032520",
            "telephone_number": "937-390-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELL",
        "first_name": "CHAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.176504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "outlook",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "n/a",
            "address_1": "2317 E Home Rd",
            "city": "Springfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "455032520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sherri L Newsome
• Kayvon F. Nezhad, D.D.S.
• Rohit K Nezhad, D.D.S.
• Cam Phuong Nguyen
• Maria Nguyen
• William David Nickell, PA-C
• Susan J. Nickels, PT
• Stone Nickerson
• Sharon Lynn Nielsen, LPCC
• Jennifer Lynn Nieves, NP

• Addiction (Substance Use Disorder) Counselor in Springfield, OH
• Providers in Springfield, 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 Jul 26, 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.