Individual provider Active NPI

Jonisha Nicholson, LPCC

  • Professional Counselor
  • Louisville, KY
National Provider Identifier
1215346192
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
169151 Issued in KY
Practice address
914 E Broadway
Louisville, KY 40204-1037
Phone
(502) 589-8600
NPI assigned
Aug 5, 2014
Last updated
Feb 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 169151 KY
Professional Counselor 101YP2500X 169151 KY Primary

Addresses

Primary practice location

914 E Broadway
Louisville, KY 40204-1037

Mailing address

70 Gray Hawk Dr
Shelbyville, KY 40065-7376
Phone (502) 320-7227

Other identifiers 2

IdentifierTypeStateIssuer
7100422430MedicaidKY
9497MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240418002120 KY Practitioner - Mental Health Counselor 5890134217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seven Counties Services, IncGroup PAC ID 1759294424, 92 clinicians

Practice addresses (Care Compare)

914 E Broadway
Louisville, KY 40204-1037
Phone (502) 587-8833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Counties Services, Inc. Counselor CurrentSince Apr 29, 2024 Accepting new patients

Locations

10401 Linn Station Rd
Ste 100
Louisville, KY 40223

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

914 E Broadway
Louisville, KY 40204
Phone (502) 587-8833

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1215346192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 GRAY HAWK DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400657376",
            "telephone_number": "502-320-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 E BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041037",
            "telephone_number": "502-589-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "JONISHA",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "KY",
            "license": "169151",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "169151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100422430",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9497",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.