Individual provider Active NPI

Lori Nicolaysen

  • Mental Health Counselor
  • Durham, NC
National Provider Identifier
1619845286
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A21696 Issued in NC
Practice address
2828 Pickett Rd # 1004
Durham, NC 27705-5872
Phone
(984) 334-2508
Fax
(919) 573-0438
NPI assigned
Oct 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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 A21696 NC Primary

Addresses

Primary practice location

2828 Pickett Rd # 1004
Durham, NC 27705-5872

Mailing address

1316 Broad St
Durham, NC 27705-3533
Phone (919) 885-6366

Other practice location 1

1316 Broad St
Durham, NC 27705-3533
Phone (919) 885-6366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A21696NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Counseling PLLC Mental Health CurrentSince Jan 4, 2026 Accepting new patients

Locations

1316 Broad St
Durham, NC 27705
Phone (919) 213-0407

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1761523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1619845286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 BROAD ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053533",
            "telephone_number": "919-885-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 PICKETT RD # 1004",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277055872",
            "telephone_number": "984-334-2508",
            "fax_number": "919-573-0438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1316 Broad St",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277053533",
            "country_code": "US",
            "telephone_number": "919-885-6366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOLAYSEN",
        "first_name": "LORI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-27",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A21696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.