Tever D Nickerson, L.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C3163 Issued in OR

Practice address

3701 SE Milwaukie Ave Ste E
Portland, OR 97202-3835

Phone

(503) 784-2377

NPI assigned

Sep 12, 2013

Last updated

Sep 12, 2013By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 30, 2025 through Apr 30, 2027

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tever Nickerson Counseling, LLC

  • Counselor
  • Portland, OR
  • NPI 1639944127
  NPD Authorized official
• Wellpath Counseling Services

  • Counselor
  • Portland, OR
  • NPI 1003306507
  Authorized official Same address or phone

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1912332651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 SE MILWAUKIE AVE STE E",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023835",
            "telephone_number": "503-784-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 SE MILWAUKIE AVE STE E",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023835",
            "telephone_number": "503-784-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "TEVER",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Phillip Nickelsen
• Jacob Nickerson, LMT
• Joshua Paul Nickerson, M.D.
• Lillian Ruth Nickerson, R.N.
• Nathan Jaylen Nickerson
• Suzanne Jensen Nicks, SLP
• Lindsey E. Nicol, M.D.
• Lauren Nicola-Ducey, M.D.
• Dennis Crandall Nicola, D.D.S.
• Teresa Nicola, LAC, DACM

• Professional Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.