Nicole Tiedt, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPCC8962 Issued in CA

Practice address

41593 Winchester Rd Ste 200
Temecula, CA 92590-4857

Phone

(951) 254-7032

NPI assigned

Sep 8, 2017

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 1

Electronic endpoints 1

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 and National Provider Directory roles.

• Nicole Tiedt, Licensed Professional Clinical Counselor, P.C.

  • Professional Counselor
  • Temecula, CA
  • NPI 1639750540

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1346768405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41593 WINCHESTER RD STE 200",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925904857",
            "telephone_number": "951-254-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41593 WINCHESTER RD STE 200",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925904857",
            "telephone_number": "951-254-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDT",
        "first_name": "NICOLE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC8962",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC8962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "LPCC8962",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicole@thrivingmindsca.com",
            "affiliation": "N",
            "address_1": "41593 Winchester Rd Ste 200",
            "city": "Temecula",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925904857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.

Verify at the official NPI Registry.