Nicole Axel Storrow

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

127449 Issued in CA

Practice address

1415 Addison Street
Berkeley, CA 94702

Phone

(510) 982-1645

NPI assigned

Jun 1, 2016

Last updated

Aug 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nico Axel Storrow Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 7, 2024 through Feb 7, 2028

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1568810489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5101",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947050101",
            "telephone_number": "510-982-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 ADDISON STREET",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94702",
            "telephone_number": "510-982-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORROW",
        "first_name": "NICOLE",
        "middle_name": "AXEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "127449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICO",
            "last_name": "STORROW",
            "middle_name": "AXEL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• David C Stone
• Larry Allen Stone, LMFT
• Shira Stone, MFT
• Natasha Stong, BCBA
• Susanna Storm, AU.D
• Sharon Stovezky
• Charles Stowell, M.D.
• Marcia Straehley, L.AC.
• Polly Strahan, M.S.
• Samuel Arola Strange, SUDCC

• Marriage & Family Therapist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.