Nickolas Fredrick Persons, LPCC #14273

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

14273 Issued in CA

Practice address

1553 Santa Clara St
Fresno, CA 93706-3447

Phone

(559) 538-1230

NPI assigned

Jan 19, 2016

Last updated

Dec 12, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Exodus Recovery, Inc.

  • Community/Behavioral Health Agency
  • Lynwood, CA
  • NPI 1174300412
  NPD (past)

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1215394499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 W SHAW AVE # 738",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937226210",
            "telephone_number": "559-977-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1553 SANTA CLARA ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937063447",
            "telephone_number": "559-538-1230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "524 S Trinity St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937061873",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4041 Plaza Dr W",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937021342",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "784 W Holland Ave",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936124800",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1828 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211008",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 N Blackstone Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937011939",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6234 E Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937271541",
            "country_code": "US",
            "telephone_number": "559-977-1001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 W Barstow Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937042156",
            "country_code": "US",
            "telephone_number": "559-538-1230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERSONS",
        "first_name": "NICKOLAS",
        "middle_name": "FREDRICK",
        "name_prefix": "Mr.",
        "credential": "LPCC #14273",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-19",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "14273",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "14273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Perry, N.P.
• Victor L. Perry, MD
• Samantha Layne Perryman
• Monte Frederick Person, D.D.S.
• Melissa Antoinette Persons, SLP
• Sarah Pervaiz, MD
• Peter J. Dorian, Audiologist, a Professional Corporation (Dorian Hearing Center)
• Peter Kwok (Medicine Shoppe)
• Peter Kwok-Jeff Lum Partnership (Medicine Shoppe)
• Peter Nassar M.D., Inc

• Professional Counselor in Fresno, CA
• Providers in Fresno, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.