Nickolas Spears Jr., LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701011855 Issued in VA

Practice address

9039 W Broad St Ste 1
Henrico, VA 23294-5842

Phone

(347) 885-2727

NPI assigned

Oct 3, 2022

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

Enrolled in VA

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.

• Gap Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Henrico, VA
  • NPI 1891419859
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1497479463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3126 W CARY ST # 409",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232213504",
            "telephone_number": "347-885-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9039 W BROAD ST STE 1",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232945842",
            "telephone_number": "347-885-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEARS",
        "first_name": "NICKOLAS",
        "name_suffix": "Jr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701011855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spain Residential Program
• Christopher Spar
• Sparkle Pediatric Dentistry
• Sarahbeth S Spasojevich, LPC
• Jennifer Spears, PT, DPT
• Specialty Nutrition and Health LLC
• Speech Connections
• Pamela J Speich, RD
• Stephanie Lynn Spencer, PHARMD
• Mary Katherine Spicer

• Mental Health Counselor in Henrico, VA
• Providers in Henrico, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.