Individual provider Active NPI

Matthew Corbin Nickles

  • Social Worker
  • Circleville, OH
National Provider Identifier
1932943594
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.2504454-TRNE Issued in OH
Practice address
145 Morris Rd
Circleville, OH 43113-1363
Phone
(740) 474-8874
NPI assigned
Jun 19, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.193115 OH
Social Worker 104100000X S.2504454-TRNE OH Primary

Addresses

Primary practice location

145 Morris Rd
Circleville, OH 43113-1363

Mailing address

PO Box 6179
Chillicothe, OH 45601-6179
Phone (740) 775-1260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CDCA.193115OHMDAddiction (Substance Use Disorder) Counselor
S.2504454-TRNEOHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Scioto Paint Valley Mental Health Center PastSince Aug 10, 2025 Accepting new patients
Scioto Paint Valley Mental Health Center PastSince Aug 10, 2025 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/spvmhc/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1932943594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6179",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456016179",
            "telephone_number": "740-775-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MORRIS RD",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431131363",
            "telephone_number": "740-474-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKLES",
        "first_name": "MATTHEW",
        "middle_name": "CORBIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-19",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.193115",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2504454-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Circleville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; 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.