Active NPI
Heather Jean Nicholson, LPC
- Professional Counselor
- Bryn Mawr, PA
National Provider Identifier
1326702580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC013776
- Practice address
- 19 Elliott Ave
Bryn Mawr, PA 19010-3407 - Phone
- (484) 929-5170
- NPI assigned
- Oct 25, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC013776 | PA | Primary |
Addresses
Primary practice location
19 Elliott Ave
Bryn Mawr, PA 19010-3407
Mailing address
4260 Manayunk Ave FL 3
Philadelphia, PA 19128-5032
Phone (484) 929-5170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC013776 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635120000000",
"number": "1326702580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4260 MANAYUNK AVE FL 3",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191285032",
"telephone_number": "484-929-5170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 ELLIOTT AVE",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103407",
"telephone_number": "484-929-5170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "HEATHER",
"middle_name": "JEAN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-25",
"last_updated": "2021-10-25",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC013776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bryn Mawr, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.