Tica Nicole Nickson, CPD, CLC, CCHW

Primary specialty

DoulaTaxonomy code 374J00000X

License

21072 Issued in PA

Practice address

650 East Ave Ste 106
Erie, PA 16503-1535

Phone

(814) 449-6200

NPI assigned

Dec 6, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Birthroot Community Doula

  • Doula
  • Erie, PA
  • NPI 1760298566

  Lactation Consultant, Non-RN

  NPD Authorized official

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1427864222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 EAST AVE STE 106",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165031535",
            "telephone_number": "814-449-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 EAST AVE STE 106",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165031535",
            "telephone_number": "814-449-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKSON",
        "first_name": "TICA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "CPD, CLC, CCHW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "PA",
            "license": "21072",
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "PA",
            "license": "21072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Lynn Nice
• Alexandria Nichols, MA CCC-SLP
• Beth Anne Nichols, PTA, ATC
• Lisa Marie Nichols, RPH
• Jamie Lynn Nick, PT
• Megan Elizabeth Nicolas, OTR
• Jennifer Niebauer
• Megan Elizabeth Nielsen
• Wendy Nielsen, R.N.
• Marissa L Niemi, PA-C

• Doula in Erie, PA
• Providers in Erie, PA by specialty
• Doula in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.