Individual provider Active NPI

Nicole Denise St. John, LCSW

  • Addiction (Substance Use Disorder) Counselor
  • Palm Beach Gardens, FL
National Provider Identifier
1295196277
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
SW11346 Issued in FL
Practice address
800 Village Square Crossing, Suite 211
Palm Beach Gardens, FL 33410
Phone
(561) 843-3357
NPI assigned
Mar 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X SW11346 FL Primary

Addresses

Primary practice location

800 Village Square Crossing, Suite 211
Palm Beach Gardens, FL 33410

Mailing address

800 Village Square Xing Ste 211
Palm Beach Gardens, FL 33410-4540
Phone (561) 843-3357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200515000634 FL Practitioner - Clinical Social Worker 6800227760 Reassigns benefits to 1 organization
Practice locations: Boca Raton, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healing Alternatives Psychotherapy, LLCGroup PAC ID 9931530995, 2 clinicians

Practice addresses (Care Compare)

800 Village Sqaure Crossing
Suite 211
Palm Beach Gardens, FL 33410-4540
Phone (561) 843-3357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Alternatives Psychotherapy, LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

800 Village Square Xing
Palm Beach Gardens, FL 33410
Phone (561) 448-6562

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1295196277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 VILLAGE SQUARE XING STE 211",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104540",
            "telephone_number": "561-843-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 VILLAGE SQUARE CROSSING, SUITE 211",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33410",
            "telephone_number": "561-843-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. JOHN",
        "first_name": "NICOLE",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-17",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "SW11346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.