Victoria Nieman

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.013417 Issued in IL

Practice address

1 E Superior St Ste 306
Chicago, IL 60611-2595

Phone

(312) 754-9404

NPI assigned

Mar 6, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Momentum Health Group, LLC

  • Adult Mental Health Clinic/Center
  • Charleston, SC
  • NPI 1710723861
  NPD Authorized official

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1073071338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1338 NORTH LASALLE",
            "address_2": "UNIT 3F",
            "city": "CHICAGO",
            "state": "ID",
            "postal_code": "60610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E SUPERIOR ST STE 306",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112595",
            "telephone_number": "312-754-9404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3665 N Broadway St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606134567",
            "country_code": "US",
            "telephone_number": "773-496-4433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEMAN",
        "first_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.013417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Lee Nielsen, MA, MACL, LPC
• Patrick E Nielsen, DPT
• Sarah Nielsen, MS
• Thomas J Nielsen, M.D.
• Mary Kiyo Nielson
• Sarah Niemann
• Amanda Niemerg, M.S., BCBA
• Katheryn Niemeyer, PHARMD
• Kole Niemi, MD
• Robyn E. Nienberg, OTR/L

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.