Active NPI
Nicole A Cleckley, LMFT
- Marriage & Family Therapist
- Philadelphia, PA
National Provider Identifier
1164633491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MF000412
- Practice address
- 4025 Chestnut St
First FL.
Philadelphia, PA 19104-3054 - Phone
- (215) 382-6680
- NPI assigned
- May 25, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MF000412 | PA | Primary |
Addresses
Primary practice location
4025 Chestnut St
First FL.
Philadelphia, PA 19104-3054
Mailing address
1011 E Washington LN
Philadelphia, PA 19138-1027
Phone (215) 382-6680
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 |
|---|---|---|---|
| MF000412 | PA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164633491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 E WASHINGTON LN",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191381027",
"telephone_number": "215-382-6680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4025 CHESTNUT ST",
"address_2": "FIRST FL.",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043054",
"telephone_number": "215-382-6680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLECKLEY",
"first_name": "NICOLE",
"middle_name": "A",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "PA",
"license": "MF000412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.