Active NPI
John Niccolls, MED
- Mental Health Counselor
- Spokane Valley, WA
National Provider Identifier
1497239099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH00005929
- Practice address
- 1102 S Raymond Rd
Spokane Valley, WA 99206-3534 - Phone
- (509) 892-4342
- NPI assigned
- Sep 19, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH00005929 | WA | Primary |
Addresses
Primary practice location
1102 S Raymond Rd
Spokane Valley, WA 99206-3534
Mailing address
1102 S Raymond Rd
Spokane Valley, WA 99206-3534
Phone (509) 892-4342
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH00005929 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537315200000",
"number": "1497239099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1102 S RAYMOND RD",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992063534",
"telephone_number": "509-892-4342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 S RAYMOND RD",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992063534",
"telephone_number": "509-892-4342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICCOLLS",
"first_name": "JOHN",
"credential": "MED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-19",
"last_updated": "2018-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH00005929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.