Individual provider Active NPI

Mikeya Nicholson, MA, LPC

  • Mental Health Counselor
  • Saint Louis, MO
National Provider Identifier
1598636755
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2024012814 Issued in MO
Practice address
1129 Macklind Ave
Saint Louis, MO 63110-1440
Phone
(314) 534-7996
Fax
(314) 534-7996
NPI assigned
Sep 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2024012814 MO Primary

Addresses

Primary practice location

1129 Macklind Ave
Saint Louis, MO 63110-1440

Mailing address

1129 Macklind Ave
Saint Louis, MO 63110-1440
Phone (314) 534-7996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20260310004247 MO Practitioner - Mental Health Counselor 9335622158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1129 Macklind Ave
Saint Louis, MO 63110-1440

367 S Gulph Rd
King of Prussia, PA 19406-3121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2024012814MOMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
St. Louis Behavioral Medicine Institute Inc CurrentSince Feb 12, 2026 Accepting new patients
St. Louis Behavioral Medicine Institute Inc Mental Health CurrentSince Feb 12, 2026 Accepting new patients

Locations

1129 Macklind Ave
Saint Louis, MO 63110
Phone (314) 534-0200

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": "1757635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1598636755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 MACKLIND AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101440",
            "telephone_number": "314-534-7996",
            "fax_number": "314-534-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 MACKLIND AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101440",
            "telephone_number": "314-534-7996",
            "fax_number": "314-534-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "MIKEYA",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-12",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2024012814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.