Wilbert Nichols III, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

9670 Issued in NC

Practice address

2905 Breezewood Ave
Suite 104
Fayetteville, NC 28303-5503

Phone

(910) 486-8989

Fax

(910) 826-3695

NPI assigned

Sep 9, 2013

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)

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 and National Provider Directory roles.

• Community Alternative Housing, Inc

  • Community/Behavioral Health Agency
  • Sanford, NC
  • NPI 1174959464
  NPD (past) Authorized official
• Community Alternative Housing, Inc.

  • Community/Behavioral Health Agency
  • Fayetteville, NC
  • NPI 1417383704
  NPD (past) Authorized official

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1447685508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87195",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283040000",
            "telephone_number": "910-486-8989",
            "fax_number": "910-826-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 BREEZEWOOD AVE",
            "address_2": "SUITE 104",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035503",
            "telephone_number": "910-486-8989",
            "fax_number": "910-826-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "WILBERT",
        "name_suffix": "III",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-09",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "9670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anpin Ni
• Marfa Merlin Nicanor, LCSWA
• Alicia Michelle Nichols-Mack
• Lylia Nichols, RN
• Qurena Nichelle Nichols, LCSWA
• Cydney Nicholson Smalls
• James Weldon Nicholson I, LCSWA
• Nicita'S Wholistic Therapeutics, LLC
• Lindsey Nickerson
• Ijada Nickle

• Mental Health Counselor in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.