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General NPI Number Information
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NPI Number | 1114538816
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Entity Type | Individual
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Provider Name | NICOLE J WELLS LISW
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Gender | Female
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Dates
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Enumeration Date | 08/14/2020
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 6939 COX RD STE 360
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City | LIBERTY TOWNSHIP
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State | OH
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Zip | 45069-7595
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Country | US
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Telephone | 513-564-6800
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Fax | 513-564-6815
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Provider Business Mailing Address
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Address Line | 2139 AUBURN AVENUE ATTN: PAYOR ENROLLMENT 4-7
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City | CINCINNATI
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State | OH
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Zip | 45219
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Country | US
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Telephone | 513-351-9900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2203956-SUPV
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License Number State | OH
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