Individual provider Active NPI

Nicole Wanzek, LPCC

  • Professional Counselor
  • Jamestown, ND
National Provider Identifier
1396112371
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
844-8-1-15-340 Issued in ND
Practice address
804 13TH St NE
Jamestown, ND 58401-3586
Phone
(701) 952-6655
NPI assigned
Aug 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 844-8-1-15-340 ND Primary

Addresses

Primary practice location

804 13TH St NE
Jamestown, ND 58401-3586

Mailing address

804 13TH St NE
Jamestown, ND 58401-3586
Phone (701) 952-6655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250418000416 ND Practitioner - Mental Health Counselor 2668997099 Receives reassigned benefits from 1 practitioner
Practice locations: Jamestown, ND

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hands Chrisitian Counseling, PLLC Professional CurrentSince Nov 1, 2022 Accepting new patients
Valley Christian Counseling Center Inc Professional PastSince Sep 1, 1993 Accepting new patients

Locations

804 13th St NE
Jamestown, ND 58401
Phone (701) 952-5566

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 2

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": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1396112371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 13TH ST NE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013586",
            "telephone_number": "701-952-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 13TH ST NE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013586",
            "telephone_number": "701-952-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANZEK",
        "first_name": "NICOLE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "844-8-1-15-340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, ND

Sources for this page

Verify at the official NPI Registry.