Healthcare Provider Details

I. General information

NPI: 1669330171
Provider Name (Legal Business Name): NICHOLAS SCALMATO PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6730 ROOSEVELT AVE STE 301
MIDDLETOWN OH
45005-5736
US

IV. Provider business mailing address

6730 ROOSEVELT AVE STE 301
MIDDLETOWN OH
45005-5736
US

V. Phone/Fax

Practice location:
  • Phone: 513-928-3339
  • Fax: 513-928-3382
Mailing address:
  • Phone: 513-928-3339
  • Fax: 513-928-3382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0041482
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN.398308
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: