Individual provider Active NPI

Catherine Ann Nickens, LMHC

  • Mental Health Counselor
  • Spokane, WA
National Provider Identifier
1801451091
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61456864 Issued in WA
Practice address
3754 W Indian Trail Rd
Spokane, WA 99208-4736
Phone
(509) 559-3100
NPI assigned
May 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X CG60880117 WA
Mental Health Counselor 101YM0800X LH61456864 WA Primary

Addresses

Primary practice location

3754 W Indian Trail Rd
Spokane, WA 99208-4736

Mailing address

3754 W Indian Trail Rd
Spokane, WA 99208-4736
Phone (509) 559-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240108000928 WA Practitioner - Mental Health Counselor 2769833490 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH61456864WAMDMental Health Counselor
CG60880117WAMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Excelsior Wellness CurrentSince Jan 1, 2024 Accepting new patients

Locations

3910 W Indian Trail Rd
Spokane, WA 99208
Phone (509) 559-3100

3754 W Indian Trail Rd
Spokane, WA 99208
Phone (509) 328-7041

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1801451091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3754 W INDIAN TRAIL RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992084736",
            "telephone_number": "509-559-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3754 W INDIAN TRAIL RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992084736",
            "telephone_number": "509-559-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKENS",
        "first_name": "CATHERINE",
        "middle_name": "ANN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-03",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": "CG60880117",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61456864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.