Jacqueline Denise Nickson-Young, GNP-BC, APMHNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP108917 Issued in TX

Practice address

512 N Hampton Rd # 303
Desoto, TX 75115-4920

Phone

(469) 734-4990

Fax

(972) 255-3958

NPI assigned

Feb 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hawkins Psychiatry PCGroup PAC ID 5395893804, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Hawkins Psychiatry PC

  • Psychiatry Physician
  • Arlington, TX
  • NPI 1003056607
  Medicare reassignment Care Compare group NPD
• Relyon Practitioner Services, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Desoto, TX
  • NPI 1811351927

  Gerontology

  Medicare reassignment NPD Authorized official
• Association for Improving Medical Accessibility Corporation

  • Family Nurse Practitioner
  • Dallas, TX
  • NPI 1538229505
  NPD (past)
• Association for Improving Medical Services

  • Assisted Living Facility
  • Lancaster, TX
  • NPI 1063606697

  Gerontology

  NPD (past)
• Hope Starts Here LLC

  • Psychiatry Physician
  • Arlington, TX
  • NPI 1053185983
  NPD (past)
• Mindful Behavioral LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Grand Prairie, TX
  • NPI 1811867872
  NPD (past)
• Physicians and Allied Health Professionals Group, PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1528011814
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1891835484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 N HAMPTON RD # 303",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154920",
            "telephone_number": "469-734-4990",
            "fax_number": "972-255-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 N HAMPTON RD # 303",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154920",
            "telephone_number": "469-734-4990",
            "fax_number": "972-255-3958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 E Broad St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760636414",
            "country_code": "US",
            "telephone_number": "817-460-7080",
            "fax_number": "682-422-3187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1229 E Pleasant Run Rd Ste 126",
            "address_purpose": "LOCATION",
            "city": "DeSoto",
            "state": "TX",
            "postal_code": "751154211",
            "country_code": "US",
            "telephone_number": "469-734-4990",
            "fax_number": "972-255-3958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKSON-YOUNG",
        "first_name": "JACQUELINE",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "GNP-BC, APMHNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "568271",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP108917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jo Ann Newton, FNP
• Next Door Therapy Services LLC
• Nexus DME LLC
• Donald Gene Nicholas Jr., M.D.
• Brenda D Nicholson, LPC
• Nicole Holman PA
• Nightingale Nurses Home Health Agency
• Gabriel Nkwanyuo, PMHNP-BC
• Noelle & Philips Home Healthcare LLC
• Noelle & Philips LLC

• Psychiatric/Mental Health Nurse Practitioner in Desoto, TX
• Providers in Desoto, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.