Healthcare Provider Details

I. General information

NPI: 1275442626
Provider Name (Legal Business Name): NICOLE MCWHIRTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 E PARK AVE
NILES OH
44446-2352
US

IV. Provider business mailing address

8285 LONGVIEW DR NE
WARREN OH
44484-1933
US

V. Phone/Fax

Practice location:
  • Phone: 330-544-8005
  • Fax:
Mailing address:
  • Phone: 330-984-2664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2411028
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: