Individual provider Active NPI

Travell Nickey, LCADC

  • Addiction (Substance Use Disorder) Counselor
  • Toms River, NJ
National Provider Identifier
1093460735
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
37LC00347900 Issued in NJ
Practice address
19 Pineview Dr
Toms River, NJ 08755-8026
Phone
(848) 223-0949
NPI assigned
Feb 21, 2022
Last updated
Feb 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00347900 NJ Primary

Addresses

Primary practice location

19 Pineview Dr
Toms River, NJ 08755-8026

Mailing address

19 Pineview Dr
Toms River, NJ 08755-8026
Phone (848) 223-0949

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address NICKEYT@kean.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37LC00347900NJMDAddiction (Substance Use Disorder) Counselor

Interoperability endpoints

  • Direct secure messaging: nickeyt@kean.edu

NPI Registry JSON

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1093460735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 PINEVIEW DR",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087558026",
            "telephone_number": "848-223-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 PINEVIEW DR",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087558026",
            "telephone_number": "848-223-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKEY",
        "first_name": "TRAVELL",
        "credential": "LCADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00347900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NICKEYT@kean.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "19 Pineview Dr",
            "city": "Toms River",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "087558026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.