Jodi Nicholson, PHD, LPC-S, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

JODI NICHOLSON, PHD, LPC-S, PLLC

Practice address

212 N Tarrant St Ste 101
Crowley, TX 76036-2593

Phone

(682) 463-1012

NPI assigned

Nov 8, 2021

Organization subpart

No

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

Authorized official

Name

Jodi Nicholson, PHD, LPC-SNPI 1215416821

Title

Licensed Professional Counselor

Phone

(682) 463-1012

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jodi Nicholson, PHD, LPC-S

  • Professional Counselor
  • Crowley, TX
  • NPI 1215416821
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1174288781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 N TARRANT ST STE 101",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760362593",
            "telephone_number": "682-463-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 N TARRANT ST STE 101",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760362593",
            "telephone_number": "682-463-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JODI NICHOLSON, PHD, LPC-S, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "682-463-1012",
        "authorized_official_credential": "PHD, LPC-S"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Crowley, TX
• Providers in Crowley, TX by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.

Verify at the official NPI Registry.