NPIMap

Organization Active NPI

Nikki Wetherell Counseling

Doing business as Virago Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, ME
National Provider Identifier
1700358314
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
NIKKI WETHERELL COUNSELING
Doing business as
Virago Wellness
Practice address
63 Ocean St
Portland, ME 04106
Phone
(207) 558-5539
NPI assigned
Dec 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Authorized official

Name
Nicole Yardy, LCPC
Title
Owner
Phone
(207) 558-5539

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

63 Ocean St
Portland, ME 04106

Mailing address

174 Blackstrap Rd
Falmouth, ME 04105-2415

Other names 1

  • Virago Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

19 South St
Ste 6
Portland, ME 04101
Phone (207) 252-8060

91 Auburn St
Ste J
Portland, ME 04103
Phone (207) 650-6670

63 Ocean St
#A
South Portland, ME 04106

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1700358314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 BLACKSTRAP RD",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041052415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 OCEAN ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-558-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIKKI WETHERELL COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-20",
        "last_updated": "2024-04-23",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "YARDY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-558-5539",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virago Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Virago Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.