Nikkala Leeann Kordzik

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

74795 Issued in TX

Practice address

433 Kitty Hawk Rd Ste 219
Universal City, TX 78148-3829

Phone

(210) 566-1280

Fax

(210) 579-8533

NPI assigned

Mar 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brightside Medical PCGroup PAC ID 6608262464, 274 clinicians

Practice addresses (Care Compare)

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.

• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1801355482

  TX

  Medicare reassignment Care Compare group NPD
• Alba Wellness Incorporated

  • Professional Counselor
  • Universal City, TX
  • NPI 1891033577
  Medicare reassignment NPD
• Solution-Focused Counseling and Play Therapy Services, PLLC

  • Professional Counselor
  • San Antonio, TX
  • NPI 1154002327

  Addiction (Substance Use Disorder)

  NPD Authorized official
• Alba Wellness Case Management LLC

  • Case Management Agency
  • Universal City, TX
  • NPI 1043877343
  NPD (past)

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1598225575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 KITTY HAWK RD STE 219",
            "city": "UNIVERSAL CITY",
            "state": "TX",
            "postal_code": "781483829",
            "telephone_number": "210-566-1280",
            "fax_number": "210-579-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 KITTY HAWK RD STE 219",
            "city": "UNIVERSAL CITY",
            "state": "TX",
            "postal_code": "781483829",
            "telephone_number": "210-566-1280",
            "fax_number": "210-579-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORDZIK",
        "first_name": "NIKKALA",
        "middle_name": "LEEANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74795",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "13761",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "74795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Ranee Karim-Alford
• Roy Kilpatrick
• Kitsune LLC
• Kitty Hawk Smiles Dentistry and Orthodontics, PC
• Jennifer Marie Knotts, LPC
• Jacob John Lamoreaux, RBT
• Helen Leona Lane
• Gregory Paul Larsen, DPM
• Patricia Leaver, PHD
• Alec Ledesma

• Mental Health Counselor in Universal City, TX
• Providers in Universal City, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.

Verify at the official NPI Registry.