Zachery Nielsen, LMHC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

105182 Issued in IA

Practice address

3350 Utica Ridge Rd
Bettendorf, IA 52722-3509

Phone

(563) 265-5063

Fax

(877) 583-4958

NPI assigned

Oct 5, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

• Bloom Wellness Group

  • Mental Health Counselor
  • Bettendorf, IA
  • NPI 1003799131

  Mental Health

  NPD Authorized official
• Bloom Business Services, LLC

  • Professional Counselor
  • Bettendorf, IA
  • NPI 1043918121

  Mental Health

  NPD

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1366049124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 UTICA RIDGE RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221616",
            "telephone_number": "563-265-5063",
            "fax_number": "877-583-4958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 UTICA RIDGE RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223509",
            "telephone_number": "563-265-5063",
            "fax_number": "877-583-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "ZACHERY",
        "credential": "LMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-05",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "105182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anh Thu Ngo
• Nicholas Nicchitta, DO
• Amanda Nichols, D.C.
• Connie Sue Nichols, LMHC, IAADC
• Laura Nichols, LCSW, BCD
• Holly J Nikels, PHD
• Peter J Nordloh, OT
• Kimberly Nicole Norris, AGACNP
• Zachary Stewart Norton, PMHNP
• Dawn M Nowell, FNP

• All providers in Bettendorf, IA
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.