Provider Demographics
NPI:1245962919
Name:COMBESS, NANNETTE (CDCA)
Entity type:Individual
Prefix:
First Name:NANNETTE
Middle Name:
Last Name:COMBESS
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 1:802 CLARE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-2583
Mailing Address - Country:US
Mailing Address - Phone:740-876-8449
Mailing Address - Fax:
Practice Address - Street 1:802 CLARE AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2583
Practice Address - Country:US
Practice Address - Phone:740-876-8449
Practice Address - Fax:888-966-0381
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.178789101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)