Individual provider Active NPI

Nikki Haynesworth, LPC

  • Professional Counselor
  • Scottsdale, AZ
National Provider Identifier
1750864500
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-21169 Issued in AZ
Practice address
7373 N Scottsdale Rd Ste A199
Scottsdale, AZ 85253-3593
Phone
(480) 524-0990
NPI assigned
Sep 7, 2018
Last updated
Jun 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 007895 NY
Professional Counselor 101YP2500X LPC-21169 AZ Primary

Addresses

Primary practice location

7373 N Scottsdale Rd Ste A199
Scottsdale, AZ 85253-3593

Mailing address

12621 N Tatum Blvd # 1629
Phoenix, AZ 85032-7710

Other practice location 1

4600 E Washington St Ste 300
Phoenix, AZ 85034-1908
Phone (602) 638-1872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240214001545 AZ Practitioner - Mental Health Counselor 0547604910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Medical PAGroup PAC ID 3678948809, 92 clinicians

Practice addresses (Care Compare)

3104 E Camelback Rd
Suite 2937
Phoenix, AZ 85016-4502
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-21169AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Jul 25, 2026 Accepting new patients
Brightside Medical, P.a. CurrentSince Jan 30, 2024 Accepting new patients
Ascend Healthcare, PLLC Mental Health PastSince Apr 24, 2021 Accepting new patients

Locations

3104 E Camelback Rd
Phoenix, AZ 85016
Phone (888) 888-9930

7373 N Scottsdale Rd
Ste A199
Scottsdale, AZ 85253
Phone (702) 805-5360

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1750864500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12621 N TATUM BLVD # 1629",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850327710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 N SCOTTSDALE RD STE A199",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852533593",
            "telephone_number": "480-524-0990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 E Washington St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850341908",
            "country_code": "US",
            "telephone_number": "602-638-1872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYNESWORTH",
        "first_name": "NIKKI",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-07",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "007895",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-21169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.