Active NPI
Laurie K Nicholson, MS, LCMHCA, NCC
- Mental Health Counselor
- Apex, NC
National Provider Identifier
1528704145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A17542
- Practice address
- 800 W Williams St Ste 280
Apex, NC 27502-5203 - Phone
- (919) 794-4799
- NPI assigned
- May 6, 2022
- Last updated
- May 6, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | A17542 | NC | Primary |
Addresses
Primary practice location
800 W Williams St Ste 280
Apex, NC 27502-5203
Mailing address
12438 Honeychurch St
Raleigh, NC 27614-8379
Phone (919) 453-3141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A17542 | NC | MD | Mental Health Counselor |
| 17542 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Mental Health | Current | Accepting new patients |
Locations
3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651795200000",
"number": "1528704145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12438 HONEYCHURCH ST",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276148379",
"telephone_number": "919-453-3141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 W WILLIAMS ST STE 280",
"city": "APEX",
"state": "NC",
"postal_code": "275025203",
"telephone_number": "919-794-4799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "LAURIE",
"middle_name": "K",
"credential": "MS, LCMHCA, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-06",
"last_updated": "2022-05-06",
"certification_date": "2022-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A17542",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Apex, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.