Individual provider Active NPI

Briana Renee Nicholson, MS, RADC-P

  • Addiction (Substance Use Disorder) Counselor
  • Farmington, MO
National Provider Identifier
1154990232
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
17825 Issued in MO
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

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
17825OtherMORADC-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

LicenseStateTypeSpecialty
17825MOMDAddiction (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.

Verify at the official NPI Registry.