Active NPI
Nancy Nilson, LPC
- Mental Health Counselor
- Southlake, TX
National Provider Identifier
1124782602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 82894
- Practice address
- 2131 Kirkwood Blvd Ste 110
Southlake, TX 76092-1530 - Phone
- (682) 593-6938
- NPI assigned
- Oct 29, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 82894 | TX | Primary |
Addresses
Primary practice location
2131 Kirkwood Blvd Ste 110
Southlake, TX 76092-1530
Mailing address
2737 Lynx LN
Fort Worth, TX 76244-4780
Phone (817) 310-0081
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
| License | State | Type | Specialty |
|---|---|---|---|
| 82894 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635465600000",
"number": "1124782602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2737 LYNX LN",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762444780",
"telephone_number": "817-310-0081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2131 KIRKWOOD BLVD STE 110",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760921530",
"telephone_number": "682-593-6938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NILSON",
"first_name": "NANCY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-29",
"last_updated": "2021-10-29",
"certification_date": "2021-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "82894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.