NPIMap

Organization Active NPI

Nicklaus Counseling Center SC

  • Professional Counselor
  • Marinette, WI
National Provider Identifier
1033659271
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2992-226 Issued in WI
Legal business name
NICKLAUS COUNSELING CENTER SC
Practice address
1557 Cleveland Ave
Marinette, WI 54143-3920
Phone
(715) 732-6868
Fax
(715) 732-6866
NPI assigned
Mar 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Christine Nicklaus, MS, MS-E, LPC-ITNPI 1386188712
Title
Owner
Phone
(715) 732-6868

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 2992-226 WI Primary

Addresses

Primary practice location

1557 Cleveland Ave
Marinette, WI 54143-3920

Mailing address

1557 Cleveland Ave
Marinette, WI 54143-3920
Phone (715) 732-6868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240705001922 WI Part B Supplier - Clinic/Group Practice 7618411315 Receives reassigned benefits from 1 practitioner
Practice locations: Marinette, WI

National Provider Directory

National Provider Directory

Locations

1557 Cleveland Ave
Marinette, WI 54143
Phone (715) 732-6868

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1033659271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1557 CLEVELAND AVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541433920",
            "telephone_number": "715-732-6868",
            "fax_number": "715-732-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1557 CLEVELAND AVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541433920",
            "telephone_number": "715-732-6868",
            "fax_number": "715-732-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICKLAUS COUNSELING CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-07",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "NICKLAUS",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-732-6868",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, MS-E, LPC-IT"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "2992-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.