Individual provider Active NPI

Nikkole Michelle Brown, LMFT

  • Marriage & Family Therapist
  • Elk Grove, CA
National Provider Identifier
1124545652
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT120603 Issued in CA
Practice address
8788 Elk Grove Blvd Ste M
Elk Grove, CA 95624-1768
Phone
(916) 701-6212
NPI assigned
Aug 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT120603 CA Primary

Addresses

Primary practice location

8788 Elk Grove Blvd Ste M
Elk Grove, CA 95624-1768

Mailing address

107 Georgetown Dr
Vacaville, CA 95687-5724
Phone (707) 641-3100

Other practice location 1

8788 Elk Grove Blvd Bldg 2
Elk Grove, CA 95624-1766
Phone (916) 956-0436

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
LMFT120603CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marriage and Family Therapy for the Integration of Healing Counselin CurrentSince Nov 7, 2025 Accepting new patients

Locations

8788 Elk Grove Blvd
Ste M
Elk Grove, CA 95624
Phone (916) 284-8336

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": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1124545652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 GEORGETOWN DR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956875724",
            "telephone_number": "707-641-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8788 ELK GROVE BLVD STE M",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956241768",
            "telephone_number": "916-701-6212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8788 Elk Grove Blvd Bldg 2",
            "address_purpose": "LOCATION",
            "city": "Elk Grove",
            "state": "CA",
            "postal_code": "956241766",
            "country_code": "US",
            "telephone_number": "916-956-0436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "NIKKOLE",
        "middle_name": "MICHELLE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT120603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.