Healthcare Provider Details

I. General information

NPI: 1598338550
Provider Name (Legal Business Name): ANGELICA ELIZABETH DOWNING CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELICA ELIZABETH NICHOLS

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 GRANT ST
AKRON OH
44311-2136
US

IV. Provider business mailing address

834 GRANT ST
AKRON OH
44311-2136
US

V. Phone/Fax

Practice location:
  • Phone: 330-253-8803
  • Fax:
Mailing address:
  • Phone: 330-253-8803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number175747
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number0001725
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: