Active NPI
Briana Renee Nicholson, MS, RADC-P
- Addiction (Substance Use Disorder) Counselor
- Farmington, MO
National Provider Identifier
1154990232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 17825
- Practice address
- 1085 Maple St
Farmington, MO 63640-1955 - Phone
- (573) 756-5353
- NPI assigned
- Jun 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 17825 | MO | Primary |
Addresses
Primary practice location
1085 Maple St
Farmington, MO 63640-1955
Mailing address
2034 Jacob LN
Farmington, MO 63640-7667
Phone (573) 366-0512
Other practice location 1
1430 Olive St Ste 400
Saint Louis, MO 63103-2303
Phone (314) 206-3700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17825 | Other | MO | RADC-P |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17825 | MO | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739318400000",
"number": "1154990232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2034 JACOB LN",
"city": "FARMINGTON",
"state": "MO",
"postal_code": "636407667",
"telephone_number": "573-366-0512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1085 MAPLE ST",
"city": "FARMINGTON",
"state": "MO",
"postal_code": "636401955",
"telephone_number": "573-756-5353"
}
],
"practiceLocations": [
{
"address_1": "1430 Olive St Ste 400",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631032303",
"country_code": "US",
"telephone_number": "314-206-3700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NICHOLSON",
"first_name": "BRIANA",
"middle_name": "RENEE",
"credential": "MS, RADC-P",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-22",
"last_updated": "2025-02-12",
"certification_date": "2025-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MO",
"license": "17825",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RADC-P",
"identifier": "17825",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Farmington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.