Nakita Dominique Cleveland Hickles, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

10085-125 Issued in WI

Practice address

5555 N Port Washington Rd Ste 200
Glendale, WI 53217-4927

Phone

(262) 999-3495

NPI assigned

Jan 14, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Nakita D Hickles Other name

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

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.

• Cornerstone Counseling Services, Inc

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246
  Medicare reassignment NPD

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1396556965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 N 52ND ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101610",
            "telephone_number": "414-460-8716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 N PORT WASHINGTON RD STE 200",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174927",
            "telephone_number": "262-999-3495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2909 N 52nd St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532101610",
            "country_code": "US",
            "telephone_number": "414-460-8716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEVELAND HICKLES",
        "first_name": "NAKITA",
        "middle_name": "DOMINIQUE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "10085-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NAKITA",
            "last_name": "HICKLES",
            "middle_name": "D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dusty Clark, PTA
• Richard Joseph Clark, PSYD
• Cleanslate Medical Group of Wisconsin, SC
• Clear Direction Psychological Services, Inc.
• Clearview Medical Imaging, LLC
• Mariah Cloutier, PT, DPT
• Elizabeth Laura Cloyd, MS CCC SLP
• Mitchell R Cohen, SAC-IT, PCTL
• Susan E Cohen, LCSW
• Maelynn D Colinco, MD

• Professional Counselor in Glendale, WI
• Providers in Glendale, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.