MEDICARE: NICOLE MATHIE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1386078962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MATHIE

Provider Business Mailing Address
First Line	:	1221 E WATERLOO RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44306-3805
Country	:	US
Telephone Number	:	234-208-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 E WATERLOO RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44306-3805
Country	:	US
Telephone Number	:	234-208-4300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2013
Last Update Date	:	11/20/2025

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Directions to “ NICOLE MATHIE ” Practice Location

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