Individual provider Active NPI

Nina Jane Falsen, LCMHC

  • Mental Health Counselor
  • Burlington, VT
National Provider Identifier
1154415867
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
068-0000641 Issued in VT
Practice address
2 Church St.
Burlington, VT 05401
Phone
(802) 233-6805
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 068-0000641 VT Primary

Addresses

Primary practice location

2 Church St.
Burlington, VT 05401

Mailing address

131 Covington Lane
Shelburne, VT 05482
Phone (802) 233-6805

Other identifiers 1

IdentifierTypeStateIssuer
1012473MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240318001878 VT Practitioner - Mental Health Counselor 9032556766 Practice locations: Burlington, VT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
068-0000641VTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
John Roos Incorporated PastSince Oct 29, 2023 Accepting new patients

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1154415867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 COVINGTON LANE",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "05482",
            "telephone_number": "802-233-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST.",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "05401",
            "telephone_number": "802-233-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALSEN",
        "first_name": "NINA",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068-0000641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012473",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.