Christopher Meltravis Nickson, M.A., PH.D.

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

5170 Hickory Hollow Pkwy Unit 175
Antioch, TN 37013-3084

Phone

(334) 434-2009

NPI assigned

Aug 31, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts, Doctor of Philosophy

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1992473326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5170 HICKORY HOLLOW PKWY UNIT 175",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133084",
            "telephone_number": "334-434-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 HICKORY HOLLOW PKWY UNIT 175",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133084",
            "telephone_number": "334-434-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "MELTRAVIS",
        "name_prefix": "Dr.",
        "credential": "M.A., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mylssacoach@gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Private Practice Email",
            "address_1": "5170 Hickory Hollow Pkwy Unit 175",
            "city": "Antioch",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370133084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Counselor in Antioch, TN
• Providers in Antioch, TN by specialty
• Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.