Nicole Rerucha, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC19228 Issued in AZ

Practice address

2620 N 140TH Ave
Goodyear, AZ 85395-2437

Phone

(602) 692-2526

NPI assigned

Feb 17, 2021

Last updated

Feb 17, 2021By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Levitan and Associates Psychological Services PLLC

  dba Levitan and Associates Psychological Services

  • Psychologist
  • Phoenix, AZ
  • NPI 1598210767
  NPD (past)

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1427641760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7427 W HILL LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853105627",
            "telephone_number": "602-692-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N 140TH AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952437",
            "telephone_number": "602-692-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RERUCHA",
        "first_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC19228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regen Advanced Infusion and Wellness
• Mikayla Rekken, DDS
• Releto Enterprise LLC (FirstLight Home Care of Goodyear)
• Reliable Behavior Home Care LLC
• Heather Leonard Renc, DMD
• Resilience Wellness Center, PLLC
• Resiliency Counseling and Consultation Services, LLC
• Resilient Star Counseling and Wellness, LLC
• Resounding Hope LLC
• Revive Medical Care

• Mental Health Counselor in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.