Debra F Nickerson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071006202 Issued in IL

Practice address

1N141 County Farm Rd
Suite 130
Winfield, IL 60190-2032

Phone

(630) 752-9725

Fax

(630) 752-9726

NPI assigned

Apr 13, 2007

Last updated

Mar 6, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 16, 2012 through May 16, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nickerson & Associates, P.C.

  • Clinical Psychologist
  • Winfield, IL
  • NPI 1467599175
  Authorized official Same address or phone
• Meek and Associates, P.C.

  • Clinical Psychologist
  • Winfield, IL
  • NPI 1124165840
  NPD (past)

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236297600000",
    "number": "1417172883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 239",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601900239",
            "telephone_number": "630-752-9725",
            "fax_number": "630-752-9726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1N141 COUNTY FARM RD",
            "address_2": "SUITE 130",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601902032",
            "telephone_number": "630-752-9725",
            "fax_number": "630-752-9726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "DEBRA",
        "middle_name": "F",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2009-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "022-32734",
            "identifier": "BCBS",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zain Nayani, DO, MPH
• Harry Nelson
• Neuromed Clinic LLC
• Jennifer Lauren Nichols, M.D.
• Nickerson & Associates, P.C.
• Anna Maria Niedzwiecki, PHARMD
• Charlotte Tsui Nielsen
• Robert Stephen Nierzwicki, M.D.
• Sandip Nijjar, FNP-C
• George Nijmeh, M.D.

• Clinical Psychologist in Winfield, IL
• Providers in Winfield, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.