Theresa Arnett Nickolaus, MAC LIMHP CIMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

9315 Issued in NE

Practice address

616 13TH St Ste 110
Aurora, NE 68818-2426

Phone

(402) 631-7267

NPI assigned

Apr 7, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

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.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Sozo Family Services

  • Mental Health Counselor
  • Aurora, NE
  • NPI 1811362726

  Addiction (Substance Use Disorder), NE

  Medicare reassignment NPD Authorized official
• Revive Inc

  • Addiction (Substance Use Disorder) Counselor
  • Hastings, NE
  • NPI 1063646479

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1447540786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 111",
            "city": "AURORA",
            "state": "NE",
            "postal_code": "688180111",
            "telephone_number": "402-631-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 13TH ST STE 110",
            "city": "AURORA",
            "state": "NE",
            "postal_code": "688182426",
            "telephone_number": "402-631-7267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 S Burlington Ave",
            "address_2": "Suite 115",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "NE",
            "postal_code": "689016960",
            "country_code": "US",
            "telephone_number": "402-462-2066",
            "fax_number": "402-462-2045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARNETT NICKOLAUS",
        "first_name": "THERESA",
        "credential": "MAC LIMHP CIMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-07",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "1520",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "9315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026546100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Michael Allen, D.D.S.
• James Benson Anderson
• Kristen J Anderson, MPAC
• Timothy L Arthur, CRNA
• Aurora Advanced Chiropractic Center
• Aurora Public School
• Balanced Vision, LLC
• Kachine Marie Banahan, APRN

• All providers in Aurora, NE
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.