Karen Nicely, LPC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

084-07-004 Issued in VA

Practice address

5268 Godwin Blvd
Suffolk, VA 23434-8135

Phone

(757) 925-2227

NPI assigned

Oct 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760579338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5268 GODWIN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348135",
            "telephone_number": "757-925-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5268 GODWIN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348135",
            "telephone_number": "757-925-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICELY",
        "first_name": "KAREN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "084-07-004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5409098",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5409071",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5400635",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derek G Newsome, SLP
• Next Level Support Services
• Khoi A Nguyen, M.D.
• Y-Minh Nguyen, PA-C
• Benedict Ngwa, NP
• Kathryn Gwaltney Nicholas, LPC
• Kaylee Nichols, OTD
• Allison Nicholson, PA-C
• Nicole Underdue Morton
• NMC Portsmouth

• Addiction (Substance Use Disorder) Counselor in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.