Jeneane C Nicodemus, LMFT

Primary specialty

CounselorTaxonomy code 101Y00000X

License

128506 Issued in CA

Practice address

518 Tamarack Creek Rd
Whitefish, MT 59937

Phone

(805) 635-7108

NPI assigned

Mar 16, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1194228023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 BAKER AVE UNIT 4687",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599377114",
            "telephone_number": "805-635-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 TAMARACK CREEK RD",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "59937",
            "telephone_number": "805-635-7108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICODEMUS",
        "first_name": "JENEANE",
        "middle_name": "C",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "128506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria Irene Nelson, OTR/L
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• Michael M Newman, M.D.
• Nancy Nguyen
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• Amy Elizabeth Nimmo, LCPC
• Andrew Norbeck
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• Counselor in Whitefish, MT
• Providers in Whitefish, MT by specialty
• Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.