Nicole Logan, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC13775 Issued in MD

Practice address

5301 Buckeystown Pike Ste 170
Frederick, MD 21704-8380

Phone

(240) 575-9688

NPI assigned

Jul 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1659942480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 W 7TH ST STE 403",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217018532",
            "telephone_number": "443-918-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 BUCKEYSTOWN PIKE STE 170",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048380",
            "telephone_number": "240-575-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "NICOLE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP11490",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC13775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zakiya N Lockhart, MD
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• Arlyn E Logan II, DDS
• Michelle D Logan, LMSW
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• Kim Marie Long, LCPC
• Longmeadow Optical

• Mental Health Counselor in Frederick, MD
• Providers in Frederick, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.