Healthcare Provider Details

I. General information

NPI: 1396257663
Provider Name (Legal Business Name): CASEY MAE NIMMO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2017
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 MADISON RD
CINCINNATI OH
45227-1491
US

IV. Provider business mailing address

4629 AICHOLTZ RD.
CINCINNATI OH
45244-1557
US

V. Phone/Fax

Practice location:
  • Phone: 513-272-2800
  • Fax: 513-272-2807
Mailing address:
  • Phone: 513-752-1555
  • Fax: 513-753-2144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2204431
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2505184
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: