Nicole Morean Nackord, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMF67996 Issued in CA

Practice address

365 Kuck LN
Petaluma, CA 94952-9606

Phone

(707) 795-6954

NPI assigned

Sep 27, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Interoperability endpoints

• Direct secure messaging: lifestancehealth.nicolenackord@148377.advancedmd-direct.com

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1750718326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 KUCK LN",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949529606",
            "telephone_number": "707-795-6954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 KUCK LN",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949529606",
            "telephone_number": "707-795-6954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACKORD",
        "first_name": "NICOLE",
        "middle_name": "MOREAN",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-27",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF67996",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "IMF67996",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF67996",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Murphy
• Diane M. Murray, MD
• Bruce Myers
• Shelby Myrick, CADC I
• N2Sleep LLC
• Stephen H Nagle
• Monica Renee Najera
• Ashley Shizu Nakagawa, MS, RD
• Hiromi Nakajima, DIETITIAN
• Azadeh Nakisa, RPH

• Mental Health Counselor in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; 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.