Luke Nicodemo

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.2613742 Issued in OH

Practice address

30 Northwest Ave Ste 120
Tallmadge, OH 44278-1808

Phone

(330) 633-4187

NPI assigned

Aug 28, 2025

Last updated

Jun 2, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• National Youth Advocate Program, Inc

  • Community/Behavioral Health Agency
  • Canton, OH
  • NPI 1679721906
  NPD (past)
• National Youth Advocate Program, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Columbus, OH
  • NPI 1952661183
  NPD (past)

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

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1457230138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 WATERMARK DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432157088",
            "telephone_number": "614-487-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NORTHWEST AVE STE 120",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442781808",
            "telephone_number": "330-633-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICODEMO",
        "first_name": "LUKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-28",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2613742",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janine Naim
• Emily Ann Neitzelt, PHARMD
• Linda Nelson, COTA/L
• Andrea Nesity
• Tiffany Nicholson, MA CCC-SLP
• Mary Jo Niece
• Crystal Noel
• Rodney Micheal Noel
• Bryce James Norman, PHARMD, RPH
• North American Indian Cultural Center, Inc.

• Social Worker in Tallmadge, OH
• Providers in Tallmadge, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.