Individual provider Active NPI

Mindy Flick

  • Addiction (Substance Use Disorder) Counselor
  • Sacramento, CA
National Provider Identifier
1114657988
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
13447 Issued in CA
Practice address
1550 Juliesse Ave
Sacramento, CA 95815-1803
Phone
(916) 921-6598
NPI assigned
Jun 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Addiction (Substance Use Disorder) Counselor 101YA0400X 13447 CA Primary

Addresses

Primary practice location

1550 Juliesse Ave
Sacramento, CA 95815-1803

Mailing address

6221 Alpinespring Way
Elk Grove, CA 95758-6108
Phone (916) 201-7096

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspace Health PastSince Jun 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mflick769532@direct.ochin.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1114657988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 ALPINESPRING WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957586108",
            "telephone_number": "916-201-7096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 JULIESSE AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958151803",
            "telephone_number": "916-921-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLICK",
        "first_name": "MINDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "13447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.