Logan Scott Nickerson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

7820 N University St
Peoria, IL 61614-1220

Phone

(309) 202-2208

NPI assigned

Nov 24, 2025

Sex

Male

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

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

{
    "created_epoch": "1763942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1427919869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W BRADLEY AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7820 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141220",
            "telephone_number": "309-202-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "LOGAN",
        "middle_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-24",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ngocyen Thi Ngo, PHARMD
• Khanh Tran Minh Nguyen
• Loan T Nguyen, APN, CNP
• Saleha Niaz
• Daysani Nichols
• Sparkle L Nicks
• Lisa K Nielsen, PA-C
• Nalleli Monserrat Nieto
• Sarah Enid Nieves, D.C.
• Mihailo Nikolic

• Mental Health Counselor in Peoria, IL
• Providers in Peoria, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; 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.