Individual provider Active NPI

Raymee Nichols

  • Addiction (Substance Use Disorder) Counselor
  • Glendale, AZ
National Provider Identifier
1346987997
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
155240 Issued in AZ
Practice address
5625 W Bell Rd Ste 100
Glendale, AZ 85308-3878
Phone
(480) 793-3573
NPI assigned
May 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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 155240 AZ Primary

Addresses

Primary practice location

5625 W Bell Rd Ste 100
Glendale, AZ 85308-3878

Mailing address

924 N Country Club Dr
Mesa, AZ 85201-4108
Phone (480) 793-3573

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

LicenseStateTypeSpecialty
155240AZMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Recovery, LLC CurrentSince Sep 5, 2023 Accepting new patients

Locations

5625 W Bell Rd
Ste 100
Glendale, AZ 85308
Phone (480) 793-3573

924 N Country Club Dr
Mesa, AZ 85201
Phone (480) 696-3800

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": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1346987997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 N COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852014108",
            "telephone_number": "480-793-3573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 W BELL RD STE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083878",
            "telephone_number": "480-793-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "RAYMEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "155240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.