Carrie A Nickles, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P1108056 Issued in AR

Practice address

109 N 48TH St
Springdale, AR 72762-3743

Phone

(303) 905-9025

Fax

(479) 358-1493

NPI assigned

Jul 28, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1083879167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 W OWL CREEK PL",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046237",
            "telephone_number": "303-905-9025",
            "fax_number": "479-358-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N 48TH ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727623743",
            "telephone_number": "303-905-9025",
            "fax_number": "479-358-1493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "322D N Bloomington St",
            "address_purpose": "LOCATION",
            "city": "Lowell",
            "state": "AR",
            "postal_code": "727459136",
            "country_code": "US",
            "telephone_number": "303-905-9025",
            "fax_number": "479-358-1493",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "60 W Sunbridge Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727031822",
            "country_code": "US",
            "telephone_number": "479-695-1240",
            "fax_number": "479-750-4843",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Viney Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Prairie Grove",
            "state": "AR",
            "postal_code": "727532623",
            "country_code": "US",
            "telephone_number": "303-905-9025",
            "fax_number": "479-358-1493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKLES",
        "first_name": "CARRIE",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P1108056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227848719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul D Nichols
• Renetta Ruth Nichols, MSN, APRN, FNP-C
• Rick D. Nichols, D.D.S
• Sherry Diane Nichols, LPN
• Matthew Nickle, P.T.
• Kyra Drewery Nielsen, COTA/L
• Nine Two Six, Inc (Oliver Pediatric Therapy Services)
• Melanie F Nix, LAC
• No Bad Days LLC
• Noble Elite Telemonitoring Services, LLC

• Mental Health Counselor in Springdale, AR
• Providers in Springdale, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.