Provider Demographics
NPI:1093606170
Name:EMIRY, NICHOLE (CDCA)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:EMIRY
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:648 MAPLE HILL DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-1728
Mailing Address - Country:US
Mailing Address - Phone:989-492-8939
Mailing Address - Fax:
Practice Address - Street 1:7058 CORPORATE WAY STE 1
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4243
Practice Address - Country:US
Practice Address - Phone:937-991-0083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)