Individual provider Active NPI

Laura Madeleine Nicholls

  • Marriage & Family Therapist
  • Grass Valley, CA
National Provider Identifier
1982739140
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC49692 Issued in CA
Practice address
714 W Main St
Grass Valley, CA 95945-6410
Phone
(530) 477-9800
Fax
(530) 477-9803
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF42452 CA
Marriage & Family Therapist 106H00000X MFC49692 CA Primary

Addresses

Primary practice location

714 W Main St
Grass Valley, CA 95945-6410

Mailing address

835 Orchard Glen Way
Grass Valley, CA 95945-5173
Phone (530) 477-9800

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

LicenseStateTypeSpecialty
IMF42452CAMDMarriage & Family Therapist
MFC49692CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1982739140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 ORCHARD GLEN WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455173",
            "telephone_number": "530-477-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W MAIN ST",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959456410",
            "telephone_number": "530-477-9800",
            "fax_number": "530-477-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLLS",
        "first_name": "LAURA",
        "middle_name": "MADELEINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF42452",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC49692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.