Active NPI
Paulina Nicholson, LPC
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1801506746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 85899
- Practice address
- 1751 River Run Ste 200
Fort Worth, TX 76107-6670 - Phone
- (682) 233-4869
- NPI assigned
- Dec 1, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 85899 | TX | Primary |
Addresses
Primary practice location
1751 River Run Ste 200
Fort Worth, TX 76107-6670
Mailing address
1704 J T Luther Dr Apt 313
Fort Worth, TX 76115-1193
Phone (817) 733-6739
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 20, 2024 through Feb 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85899 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669852800000",
"number": "1801506746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1704 J T LUTHER DR APT 313",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761151193",
"telephone_number": "817-733-6739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1751 RIVER RUN STE 200",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761076670",
"telephone_number": "682-233-4869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "PAULINA",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-01",
"last_updated": "2022-12-01",
"certification_date": "2022-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "85899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.