MEDICARE: MELYNDA NICKLES LSW

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	104100000X	Social Worker	S.0031061	OH
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1871926386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELYNDA NICKLES LSW

Provider Business Mailing Address
First Line	:	1801 WATERMARK DR
Second Line	:	STE 200
City	:	COLUMBUS
State	:	OH
Zip	:	43215-7088
Country	:	US
Telephone Number	:	888-688-9964
Fax Number	:

Provider Business Practice Location Address
First Line	:	4130 LINDEN AVE
Second Line	:	STE 390
City	:	DAYTON
State	:	OH
Zip	:	45432-3015
Country	:	US
Telephone Number	:	800-259-3454
Fax Number	:	937-253-0707

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

Provider Enumeration Date	:	08/20/2013
Last Update Date	:	02/17/2023

Similar Medicare Providers

1093648610 — UTOPIA THERAPEUTICS LLC
Practice Location Address:

4130 LINDEN AVE
DAYTON, OH
45432-3015

Practice Phone: 937-479-9797
Practice Fax:

1881684769 — DR. MARY ANN JONES PH.D.
Practice Location Address:

4130 LINDEN AVE , SUITE 309
DAYTON, OH
45432-3015

Practice Phone: 937-254-7301
Practice Fax: 937-254-2117

1740266683 — DR. MICHAEL ALAN WILLIAMS ED.D.
Practice Location Address:

4130 LINDEN AVE , SUITE 309
DAYTON, OH
45432-3015

Practice Phone: 937-254-7301
Practice Fax: 937-254-2117

1184663379 — DR. TYRONE PAYNE PH.D.
Practice Location Address:

4130 LINDEN AVE , SUITE 309
DAYTON, OH
45432-3015

Practice Phone: 937-254-7301
Practice Fax: 937-254-2117

1790059509 — KATHERINE L COOPER LSW
Practice Location Address:

4130 LINDEN AVE , STE 390
DAYTON, OH
45432-3015

Practice Phone: 800-259-3454
Practice Fax: 937-253-0707

1487928289 — TAMI A ROLL LSW
Practice Location Address:

4130 LINDEN AVE , STE 390
DAYTON, OH
45432-3015

Practice Phone: 800-259-3454
Practice Fax: 937-253-0707

Directions to “ MELYNDA NICKLES LSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.