Carl Nickeson, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY2477 Issued in FL

Practice address

1635 E Robinson St
Orlando, FL 32803-5932

Phone

(407) 898-8544

Fax

(407) 898-9384

NPI assigned

Dec 1, 2006

Sex

Male

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)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265500987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 E ROBINSON ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035932",
            "telephone_number": "407-898-8544",
            "fax_number": "407-898-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 E ROBINSON ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035932",
            "telephone_number": "407-898-8544",
            "fax_number": "407-898-9384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKESON",
        "first_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY2477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Nichols, RMHCI, RMFT
• Nickcold Savoir Nicholson, DC
• Tansyla Keels Nicholson, MD
• Brian J Nickerson, ATC
• Eric Michael Nickeson-Mendheim, LCSW
• Jenny Kidd Nickless, DNP, ARNP
• Nancie L Nickless, CRNA
• Tammy Nicol
• Rania Soliman Nicola, DDS
• Valeria G Nicolao Uztariz, BEHAVIOR TECHNICIAN

• Psychologist in Orlando, FL
• Providers in Orlando, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.