Active NPI
Nina Hickman, LPC
- Mental Health Counselor
- Minneapolis, MN
National Provider Identifier
1821516139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 01603
- Practice address
- 3033 Excelsior Blvd Ste 465
Minneapolis, MN 55416-3372 - Phone
- (612) 964-8252
- NPI assigned
- Sep 7, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 01603 | MN | Primary |
Addresses
Primary practice location
3033 Excelsior Blvd Ste 465
Minneapolis, MN 55416-3372
Mailing address
4610 Minnetonka Blvd
St Louis Park, MN 55416-4032
Phone (612) 964-8252
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01603 | MN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504742400000",
"number": "1821516139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4610 MINNETONKA BLVD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554164032",
"telephone_number": "612-964-8252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3033 EXCELSIOR BLVD STE 465",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554163372",
"telephone_number": "612-964-8252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "NINA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-07",
"last_updated": "2017-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "01603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.