Individual provider Active NPI

Darrin Todd Nickel, LCMFT

  • Marriage & Family Therapist
  • Wichita, KS
National Provider Identifier
1174893382
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LCMFT 776 Issued in KS
Practice address
2001 N Maize Rd
Wichita, KS 67212-5205
Phone
(316) 722-8020
Fax
(316) 722-4297
NPI assigned
Jan 4, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LCMFT 776 KS Primary

Addresses

Primary practice location

2001 N Maize Rd
Wichita, KS 67212-5205

Mailing address

2001 N Maize Rd
Wichita, KS 67212-5205
Phone (316) 722-8020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • 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
I20240605000421 KS Practitioner - Marriage and Family Therapist 3779025812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axiom Counseling and Therapy ServicesGroup PAC ID 7618408816, 6 clinicians

Practice addresses (Care Compare)

7570 W 21St St N
BLDG 1020 Suite B
Wichita, KS 67205-1734
Phone (316) 239-1880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCMFT 776KSMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Axiom Counseling & Therapy Services Marriage & Family Therapist CurrentSince Aug 7, 2024 Accepting new patients
Pathway Church Marriage & Family Therapist Past Accepting new patients

Locations

7570 W 21st St N
Ste 1020B
Wichita, KS 67205
Phone (316) 239-1880

Organizations & group practices 2

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": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1174893382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N MAIZE RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672125205",
            "telephone_number": "316-722-8020",
            "fax_number": "316-722-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N MAIZE RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672125205",
            "telephone_number": "316-722-8020",
            "fax_number": "316-722-4297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKEL",
        "first_name": "DARRIN TODD",
        "credential": "LCMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "LCMFT 776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.