Mackenzie Nickerson, LADC, CCS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LC7602 Issued in ME

Practice address

6 Digital Dr
Biddeford, ME 04005-4418

Phone

(207) 800-3347

NPI assigned

May 12, 2020

Last updated

Jun 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Ibex Recovery, LLC

  dba Portland Treatment

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Biddeford, ME
  • NPI 1790559888
  NPD
• Cap Quality Care, Inc.

  • Methadone Clinic
  • Westbrook, ME
  • NPI 1184762247
  NPD (past)
• State of Maine

  dba Riverview Psychiatric Hospital

  • Psychiatric Hospital
  • Augusta, ME
  • NPI 1053319566
  NPD (past)

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1336761444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 DIGITAL DR",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040054418",
            "telephone_number": "207-800-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 DIGITAL DR",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040054418",
            "telephone_number": "207-800-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "MACKENZIE",
        "credential": "LADC, CCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC7602",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "CCS7931",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADC",
            "identifier": "LC7602",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCS",
            "identifier": "CCS7931",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• New England Denture Center of Westbrook
• New Mind Institute LLC
• Paul Edward Newton II, D.C.
• Kayleigh Neyer, OTR/L
• Ornella Nina Nezerwe
• Nancy M Nickerson, GNP
• Jeff Nicoletti, P.A.
• Morgin Kodie Niedermeier, PT
• Jillian Nielsen, RD, CSP, LD, CNSC
• Douglas George Nilson, MD

• Addiction (Substance Use Disorder) Counselor in Biddeford, ME
• Providers in Biddeford, ME by specialty
• Addiction (Substance Use Disorder) Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.