Individual provider Active NPI

Mark Nickolas

  • Mental Health Counselor
  • Lynn, MA
National Provider Identifier
1851656458
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7926 Issued in MA
Practice address
23 Brookline St
Lynn, MA 01902-1807
Phone
(617) 501-1083
NPI assigned
Jul 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7926 MA Primary

Addresses

Primary practice location

23 Brookline St
Lynn, MA 01902-1807

Mailing address

23 Brookline St
Lynn, MA 01902-1807
Phone (617) 501-1083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20240130003502 MA Practitioner - Mental Health Counselor 1759734312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23 Brookline St
Lynn, MA 01902-1807
Phone (617) 501-1083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Resources Counseling, PC CurrentSince Nov 7, 2023 Accepting new patients
Thrive Counseling LLC Mental Health PastSince Aug 10, 2018 Accepting new patients

Organizations & group practices 2

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": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1851656458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 BROOKLINE ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019021807",
            "telephone_number": "617-501-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 BROOKLINE ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019021807",
            "telephone_number": "617-501-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKOLAS",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-10",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "7926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.