Inner Resources Counseling, PC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

INNER RESOURCES COUNSELING, PC

Practice address

74 Atlantic Ave
Marblehead, MA 01945-3066

Phone

(617) 501-1083

NPI assigned

Oct 2, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Mark Achilles Nickolas, PHD, LMHCNPI 1851656458

Title

President

Phone

(617) 501-1083

Specialties & licenses 2

Addresses

Other names 1

• Inner Resources Counseling Former legal business name

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Nickolas

  • Mental Health Counselor
  • Lynn, MA
  • NPI 1851656458
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601596800000",
    "number": "1669079729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 BROOKLINE ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019021807",
            "telephone_number": "617-501-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 ATLANTIC AVE",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019453066",
            "telephone_number": "617-501-1083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23 Brookline St",
            "address_purpose": "LOCATION",
            "city": "Lynn",
            "state": "MA",
            "postal_code": "019021807",
            "country_code": "US",
            "telephone_number": "617-501-1083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INNER RESOURCES COUNSELING, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A",
        "authorized_official_last_name": "NICKOLAS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ACHILLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-501-1083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inner Resources Counseling",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Marblehead, MA
• Providers in Marblehead, MA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.