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NPI Code Detail

MEDICARE: ARIEL MARIE MIKESELL CDCA

MEDICARE: ARIEL MARIE MIKESELL CDCA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.182357OH

General Provider Information

NPI Number : 1003452376
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARIEL MARIE MIKESELL CDCA
Provider Business Mailing Address
First Line : 4600 MONTGOMERY RD STE 400
Second Line :
City : CINCINNATI
State : OH
Zip : 45212-2600
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5464 BURKHARDT RD
Second Line :
City : DAYTON
State : OH
Zip : 45431-2112
Country : US
Telephone Number : 833-510-4357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2019
Last Update Date : 10/31/2023

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Directions to “ ARIEL MARIE MIKESELL CDCA” Practice Location

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