Individual provider Active NPI

Nickolas Macaluso, LPC

  • Clinical Psychologist
  • Atchison, KS
National Provider Identifier
1588060362
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2402 Issued in KS
Practice address
201 Main St
Atchison, KS 66002-2838
Phone
(913) 367-1593
Fax
(913) 367-1627
NPI assigned
Nov 6, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2402 KS Primary

Addresses

Primary practice location

201 Main St
Atchison, KS 66002-2838

Mailing address

500 Limit St
Leavenworth, KS 66048-4435
Phone (913) 682-5118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20160328001523 KS Practitioner - Clinical Psychologist 0547567083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Guidance Center, IncGroup PAC ID 6507859063, 13 clinicians

Practice addresses (Care Compare)

201 Main St
Suite 100
Atchison, KS 66002-2828
Phone (913) 367-1593

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2402KSMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Guidance Center, Inc CurrentSince Mar 4, 2016 Accepting new patients
The Guidance Center, Inc PastSince Mar 4, 2016 Accepting new patients

Locations

201 Main St
Ste 100
Atchison, KS 66002
Phone (913) 367-1593

500 Limit St
Leavenworth, KS 66048
Phone (913) 682-5118

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1588060362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LIMIT ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660484435",
            "telephone_number": "913-682-5118",
            "fax_number": "913-682-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MAIN ST",
            "city": "ATCHISON",
            "state": "KS",
            "postal_code": "660022838",
            "telephone_number": "913-367-1593",
            "fax_number": "913-367-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACALUSO",
        "first_name": "NICKOLAS",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-06",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "2402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atchison, KS

Sources for this page

Verify at the official NPI Registry.