Individual provider Active NPI

Heather Denise Nickell, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Louisa, KY
National Provider Identifier
1811562168
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3015520 Issued in KY
Practice address
203 S Water St
Louisa, KY 41230-1347
Phone
(606) 649-2211
Fax
(606) 638-1399
NPI assigned
May 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3015520 KY Primary

Addresses

Primary practice location

203 S Water St
Louisa, KY 41230-1347

Mailing address

PO Box 726
Louisa, KY 41230-0726
Phone (606) 638-0938

Other practice location 1

125 S Main Cross St
Louisa, KY 41230-1330
Phone (606) 638-0938

Other practice location 2

50 Recovery Dr
Ashland, KY 41101-8800
Phone (606) 220-0010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210701002382 KY Practitioner - Nurse Practitioner 8224439906 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3015520KYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Counseling Center, LLC Nurse Practitioner CurrentSince Oct 31, 2022 Accepting new patients
Pioneer Health Group LLC Past Accepting new patients
Pioneer Health Group LLC PastSince Jul 21, 2024 Accepting new patients
Arc Health Systems, LLC PastSince Apr 21, 2024 Accepting new patients

Locations

1353 W Main St
Lexington, KY 40508

1169 Eastern Pkwy
Ste 3328
Louisville, KY 40217
Phone (205) 914-2526

Organizations & group practices 4

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": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1811562168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 726",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412300726",
            "telephone_number": "606-638-0938",
            "fax_number": "859-813-5394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S WATER ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301347",
            "telephone_number": "606-649-2211",
            "fax_number": "606-638-1399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 S Main Cross St",
            "address_purpose": "LOCATION",
            "city": "Louisa",
            "state": "KY",
            "postal_code": "412301330",
            "country_code": "US",
            "telephone_number": "606-638-0938",
            "fax_number": "859-813-5394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Recovery Dr",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "KY",
            "postal_code": "411018800",
            "country_code": "US",
            "telephone_number": "606-220-0010",
            "fax_number": "606-744-1875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKELL",
        "first_name": "HEATHER",
        "middle_name": "DENISE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3015520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisa, KY

Sources for this page

Verify at the official NPI Registry.