Nicholas J Gambino, MSW
Individual provider Active NPI Mental Health Counselor · Bellbrook, OH
NPI 1609030204 · NPPES record last updated Jul 12, 2008
Key facts
- NPI
- 1609030204
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- I-0001586 (OH)
- Practice address
- 4301 State Route 725 Ste B
Bellbrook, OH 45305-1552 - Phone
- (937) 848-9858
- Fax
- (937) 848-2080
- NPI assigned
- Jul 12, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-0001586 | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maier Psychological Services LTD | Past |
Accepting new patients | |
| Marl E Reynolds MD Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | I-0001586 | OH | Yes |
Addresses
Primary practice location
4301 State Route 725 Ste B
Bellbrook, OH 45305-1552
Mailing address
511 N Heincke Rd
Miamisburg, OH 45342-2639
Phone (937) 859-7062
Other providers in Bellbrook, OH
- Jason John Fisher
- Five Stones Therapy, LLC
- Mallory Shae Fochtman
- Margaret Clare Foley
- Charles Fubler
- Cynthia Gebhart
- Evan Geist
- Kenneth R. Gilfillan
- Amber C Gomez
- Lauren Graves
All providers in Bellbrook, OH · Mental Health Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.