Leave Your Mark Life Coaching

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Legal business name

LEAVE YOUR MARK LIFE COACHING

Practice address

762 Independence Blvd Ste 786
Virginia Beach, VA 23455-6200

Phone

(757) 493-1514

NPI assigned

Sep 6, 2023

Organization subpart

No

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

Authorized official

Name

Nickolas Nichols, LMFTNPI 1760900716

Title

LMFT/Owner

Phone

(757) 493-1514

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Nickolas Scott Nichols, LMFT

  • Marriage & Family Therapist
  • Virginia Beach, VA
  • NPI 1760900716
  NPD Authorized official

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1699551507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 INDEPENDENCE BLVD STE 786",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556200",
            "telephone_number": "757-493-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 INDEPENDENCE BLVD STE 786",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556200",
            "telephone_number": "757-493-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAVE YOUR MARK LIFE COACHING",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "NICKOLAS",
        "authorized_official_title_or_position": "LMFT/OWNER",
        "authorized_official_telephone_number": "757-493-1514",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tierra Nicole Leak, MD
• Learning First LLC
• Ashley Darden Leary
• Michael Leary
• Tina Denise Leatherbury
• Diane Leavitt
• Kenneth A Lebow, O.D., F.A.A.O.
• Alison Leclaire
• Ivana Jeanne Leclerc, MS,LPCR
• Cheyenne Danae Ledbetter, RBT

• Counseling Psychologist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Counseling Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.