Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary Nichole Funkhouser, CDCA

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1457117954

Mary Nichole Funkhouser, CDCA is an Addiction (Substance Use Disorder) Counselor in Xenia, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2024

Practice location Address checks out

215 S Allison Ave
Xenia, OH 45385-3694
Phone: (937) 352-6490
Fax: (937) 888-4008
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CDCA.192961 (OH)

Record details

NPI number1457117954
Entity typeIndividual (Type 1)
GenderFemale
Credentials CDCA
Sole proprietorYes
NPI enumeratedFebruary 22, 2024
Last updated in NPPESNovember 12, 2025
Certification dateNovember 12, 2025

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