Individual provider Active NPI

Nicole Grace Sirko, LPC

  • Professional Counselor
  • Virginia Beach, VA
National Provider Identifier
1821228289
Registry record updated Dec 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701004345 Issued in VA
Practice address
316 Office Square LN Ste 101
Virginia Beach, VA 23462-3651
Phone
(757) 279-8058
NPI assigned
Jul 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701004345 VA Primary

Addresses

Primary practice location

316 Office Square LN Ste 101
Virginia Beach, VA 23462-3651

Mailing address

316 Office Square LN Ste 101
Virginia Beach, VA 23462-3651
Phone (757) 279-8058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 7, 2025 through Apr 7, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0701004345VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sunlight Counseling PLLC Professional Current Accepting new patients
Seven Cities Therapy, PLLC PastSince May 21, 2023 Accepting new patients
Atlantic Family and Adolescent Therapy, PLLC PastSince Oct 1, 2022 Accepting new patients

Locations

5705 Lynnhaven Pkwy
Ste 104
Virginia Beach, VA 23464
Phone (704) 561-1143

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703462400000",
    "number": "1821228289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 OFFICE SQUARE LN STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623651",
            "telephone_number": "757-279-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 OFFICE SQUARE LN STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623651",
            "telephone_number": "757-279-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRKO",
        "first_name": "NICOLE",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-20",
        "last_updated": "2023-12-25",
        "certification_date": "2023-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.