MR. KIRK LELAND NICKISON (NPI# 1467949875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467949875 |
| Entity Type | Individual |
| Full Name | MR. KIRK LELAND NICKISON |
| Credential | QBHS |
| Practice Address |
303 Offnere St Portsmouth OH 45662-4655 |
| Practice Telephone | 7408769369 |
| Mailing Telephone | 7408769369 |
| Mailing Fax Number | 7408769213 |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2018-04-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
OH | Behavioral Health & Social Service Providers |
| Street Address |
303 OFFNERE ST |
| City | PORTSMOUTH |
| State | OH |
| Zip Code | 45662-4655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336654854 | Phoenix Group Home | Community/Behavioral Health | 303 Offnere St, Portsmouth, OH 45662-4655 | 2017-12-06 |
| 1588144414 | Carrie Burchett | Case Manager/Care Coordinator | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-08-20 |
| 1457839375 | Tristin Fay Jenkins | Registered Nurse | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-08-02 |
| 1750868121 | Sue Carol Lehman | Social Worker | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-07-27 |
| 1841777463 | Carlena Smith | Case Manager/Care Coordinator | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-07-26 |
| 1891271052 | Devin Allen Spurgeon | Case Management | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-07-11 |
| 1962997932 | Jordan Lee Kennard | Case Manager/Care Coordinator | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-06-22 |
| 1427542901 | Bryant Christopher Jamison | Case Manager/Care Coordinator | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-06-19 |
| 1063906543 | Michael Green | Case Manager/Care Coordinator | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-06-19 |
| 1336632223 | Danette S Dyke | Registered Nurse | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528613346 | Stacia N Boyer | Nurse Practitioner | 1611 27th Street, Fulton Bldg Suite 101, Portsmouth, OH 45662 | 2019-08-08 |
| 1487210167 | Rose Speier | Registered Nurse | 920 Gallia Street, Portsmouth, OH 45662 | 2019-05-17 |
| 1083123491 | Megan Rhea | Case Manager/Care Coordinator | 901 Wahington St, Portsmouth, OH 45662 | 2017-09-28 |
| 1376061903 | Alanna Lee Reisinger | Physical Therapist | 522 Glenwood Ave., New Boston, OH 45662 | 2017-09-04 |
| 1871010967 | Nicole Lynne Johnson | Counselor | 800 Gallia Street Suite 600, Portsmouth, OH 45662 | 2017-08-29 |
| 1629595822 | William Zachary Nance | Counselor | 800 Gallia Street, Suite 600, Portsmouth, OH 45662 | 2017-08-28 |
| 1962929703 | Melissa Rodbell | Speech-Language Pathologist | 514 Union St., Portsmouth, OH 45662 | 2017-08-23 |
| 1346604626 | Todd Davis | Counselor | 2954 Walnut St., Portsmouth, OH 45662 | 2016-04-12 |
| 1083078406 | Gordon Sanders | Counselor | 2954 Walnut Street, Portsmouth, OH 45662 | 2016-04-12 |
| 1033573910 | Michael L Purdy | Nurse Practitioner | 1735 27th Street Waller Bldg Suite 302, Portsmouth, OH 45662 | 2016-04-07 |
| Find all providers in zip 45662 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457990285 | Keisha Nicole Whitney | Counselor | 201 Wynn St, Portsmouth, VA 23701-3141 | 2019-12-26 |
| 1326680877 | Kennedy Counseling Group | Counselor | 100 7th St Ste 104, Portsmouth, VA 23704-4800 | 2019-10-16 |
| 1508410382 | Ricky Lee Key Sr. | Counselor | Kaleidoscope Counseling and Case Management, 1712 Airline Blvd, Portsmouth, VA 23707 | 2019-07-30 |
| 1841857737 | Psychological Associates of Greater Hampton Roads Pllc | Counselor | 355 Crawford St Ste 333, Portsmouth, VA 23704-2819 | 2019-05-25 |
| 1831756790 | Breakthrough Therapeutic Supportive Services LLC | Counselor | 3026 Tyre Neck Road Ste J, Portsmouth, VA 23703-2526 | 2019-05-24 |
| 1457918427 | Dorla Johnson | Counselor | 3026 Tyre Neck Rd Ste J, Portsmouth, VA 23703-4500 | 2019-05-23 |
| 1467015834 | Glascow Health Services LLC | Counselor | 301 Goode Way Ste 105, Portsmouth, VA 23704-2266 | 2019-04-20 |
| 1922562909 | Dominique Myrick | Counselor | 528 Dry Run Rd, Portsmouth, OH 45663-8988 | 2019-01-24 |
| 1710466354 | Jennifer Cortes Morgan | Counselor | 355 Crawford St Ste 322, Portsmouth, VA 23704-2819 | 2018-08-13 |
| 1598272486 | Katelyn Gelineau | Counselor | 426 Middle St, Portsmouth, NH 03801-5017 | 2018-01-02 |
| Find all providers in PORTSMOUTH | ||||
| City | PORTSMOUTH |
| Zip Code | 45662 |
Please comment or provide details below to improve the information on MR. KIRK LELAND NICKISON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.