Steven Niel Nickolaisen, PHD, MA

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

8152100-2501 Issued in UT

Practice address

1208 E 3300 S
Salt Lake City, UT 84106-2522

Phone

(801) 483-1600

NPI assigned

May 21, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Davis Psychological ServicesGroup PAC ID 0446511927, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Philosophy

Practice roles

Locations

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.

• South Davis Psychological Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Centerville, UT
  • NPI 1386142396
  Medicare reassignment Care Compare group NPD
• Comprehensive Psychological Services Inc

  • Psychologist
  • Salt Lake City, UT
  • NPI 1407878333
  Medicare reassignment NPD
• Neurorev PLLC

  • Physical Therapy Clinic/Center
  • Centerville, UT
  • NPI 1598229155
  NPD

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1841857315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 S 1100 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841023902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062522",
            "telephone_number": "801-483-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKOLAISEN",
        "first_name": "STEVEN",
        "middle_name": "NIEL",
        "name_prefix": "Dr.",
        "credential": "PHD, MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "UT",
            "license": "8152100-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Victoria Nickel, APRN
• Joshua Nickels, RN
• Stacy Lynn Nickels, BS
• Cheryl Sharpe Nickisch, PT
• Florian Nickisch, MD
• Hanna Nicol, APRN, DNP, FNP-C
• Theresa S Nicolas
• Kimberly Jane Niday, MA, CCC/A
• Kajay Ann Niebrugge, CSW
• Krista Lee Niederjohn, CSW, MSW, MED

• Counseling Psychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Counseling Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.