Individual provider Active NPI

Nicole Herdoiza, LPC

  • Professional Counselor
  • South Lyon, MI
National Provider Identifier
1578343182
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401226260 Issued in MI
Practice address
127 N Lafayette St
South Lyon, MI 48178-1210
Phone
(248) 573-7417
NPI assigned
Oct 2, 2023
Last updated
Jul 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401226260 MI Primary
Professional Counselor 101YP2500X 6451023188 MI

Addresses

Primary practice location

127 N Lafayette St
South Lyon, MI 48178-1210

Mailing address

127 N Lafayette St
South Lyon, MI 48178-1210
Phone (248) 573-7417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20260609001247 MI Practitioner - Mental Health Counselor 7113498304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

127 N Lafayette St
South Lyon, MI 48178-1210

4567 Lilly CT
West Bloomfield, MI 48323-4009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401226260MIMDProfessional Counselor
6451023188MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lyon Counseling Center CurrentSince Jun 20, 2023 Accepting new patients

Locations

127 N Lafayette St
South Lyon, MI 48178
Phone (248) 573-7417

415 S Lafayette St
Ste 104
South Lyon, MI 48178
Phone (248) 573-7417

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": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1578343182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 N LAFAYETTE ST",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781210",
            "telephone_number": "248-573-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 N LAFAYETTE ST",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781210",
            "telephone_number": "248-573-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERDOIZA",
        "first_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401226260",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6451023188",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lyon, MI

Sources for this page

Verify at the official NPI Registry.