Individual provider Active NPI

Nikki Brown, LPC

  • Professional Counselor
  • Dallas, TX
National Provider Identifier
1104243724
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
76052 Issued in TX
Practice address
4801 Spring Valley Rd Ste 20
Dallas, TX 75244-8248
Phone
(469) 785-8441
NPI assigned
Mar 20, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X 76052 TX Primary

Addresses

Primary practice location

4801 Spring Valley Rd Ste 20
Dallas, TX 75244-8248

Mailing address

625 N Town East Blvd Apt 525
Mesquite, TX 75150-8337
Phone (469) 785-8441

Other practice location 1

2905 Breezewood Ave
Suite 104
Fayetteville, NC 28303-5503
Phone (910) 486-8989

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
76052TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1104243724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N TOWN EAST BLVD APT 525",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751508337",
            "telephone_number": "469-785-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 SPRING VALLEY RD STE 20",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752448248",
            "telephone_number": "469-785-8441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2905 Breezewood Ave",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283035503",
            "country_code": "US",
            "telephone_number": "910-486-8989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "NIKKI",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-20",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "76052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.