Healthcare Provider Details

I. General information

NPI: 1619691094
Provider Name (Legal Business Name): NICOLETTA GEAR CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NICOLETTE SPAGNOLA

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2737 YOUNGSTOWN RD SE
WARREN OH
44484-5002
US

IV. Provider business mailing address

2737 YOUNGSTOWN RD SE
WARREN OH
44484-5002
US

V. Phone/Fax

Practice location:
  • Phone: 330-369-8022
  • Fax:
Mailing address:
  • Phone: 330-369-8022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: