Provider Demographics
NPI:1679166417
Name:SHOWMAN, NICOLE M (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:SHOWMAN
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:M
Other - Last Name:ADDIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA, SWT
Mailing Address - Street 1:2845 BELL ST
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1720
Mailing Address - Country:US
Mailing Address - Phone:740-454-9766
Mailing Address - Fax:740-588-6452
Practice Address - Street 1:3405 DILLON ACRES DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-9658
Practice Address - Country:US
Practice Address - Phone:740-455-4132
Practice Address - Fax:740-455-5322
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2101684-TRNE104100000X
OHS.2208575104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker