Individual provider Active NPI

Melissa Catherine Nicholson, M.A., LMFT

  • Marriage & Family Therapist
  • Hinsdale, IL
National Provider Identifier
1417471533
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166.001234 Issued in IL
Practice address
15 Spinning Wheel Rd.
Suite 125
Hinsdale, IL 60521
Phone
(952) 292-6941
Fax
(630) 974-6263
NPI assigned
Jul 31, 2017
Last updated
Feb 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166.001234 IL Primary

Addresses

Primary practice location

15 Spinning Wheel Rd.
Suite 125
Hinsdale, IL 60521

Mailing address

15 Spinning Wheel Rd.
Suite 125
Hinsdale, IL 60521
Phone (952) 292-6941

Other names 1

  • Melissa Catherine Ludzack Former name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
166.001234ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Counseling Center, PC PastSince Jul 1, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1417471533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SPINNING WHEEL RD.",
            "address_2": "SUITE 125",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "60521",
            "telephone_number": "952-292-6941",
            "fax_number": "630-974-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SPINNING WHEEL RD.",
            "address_2": "SUITE 125",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "60521",
            "telephone_number": "952-292-6941",
            "fax_number": "630-974-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "MELISSA",
        "middle_name": "CATHERINE",
        "credential": "M.A., LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.001234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "LUDZACK",
            "middle_name": "CATHERINE",
            "credential": "M.A., LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hinsdale, IL

Sources for this page

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