Healthcare Provider Details

I. General information

NPI: 1811802408
Provider Name (Legal Business Name): MRS. NICOLA ANN ESSEX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 HARVESTHOME CIR UNIT D
DAYTON OH
45449-3567
US

IV. Provider business mailing address

626 HARVESTHOME CIR UNIT D
DAYTON OH
45449-3567
US

V. Phone/Fax

Practice location:
  • Phone: 937-304-4964
  • Fax:
Mailing address:
  • Phone: 937-304-4964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: