Healthcare Provider Details

I. General information

NPI: 1245147156
Provider Name (Legal Business Name): NICHOLE ANNETTE AVES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7485 BEECHER RD SW
PATASKALA OH
43062-8586
US

IV. Provider business mailing address

7485 BEECHER RD SW
PATASKALA OH
43062-8586
US

V. Phone/Fax

Practice location:
  • Phone: 614-205-0530
  • Fax:
Mailing address:
  • Phone: 614-205-0530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2608478
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: