MAUDE LAVERNE NICKOLOFF (NPI# 1629544978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629544978 |
| Entity Type | Individual |
| Full Name | MAUDE LAVERNE NICKOLOFF |
| Credential | CDP |
| Practice Address |
2280 Wa-821 Yakima WA 98901 |
| Mailing Address |
Po Box 217 Selah WA 98942-0217 |
| Practice Telephone | 5094570990 |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2018-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | CP0000426 | 05 |
| Street Address |
2280 WA-821 |
| City | YAKIMA |
| State | WA |
| Zip Code | 98901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043798267 | Amber Ann Couture | Counselor | 2280 Wa-821, Yakima, WA 98901 | 2018-07-31 |
| 1962020081 | Roseanne Marie Johnson | Counselor | 2280 Wa-821, Yakima, WA 98901 | 2020-07-07 |
| 1467078022 | Isaac John Mcgahan | Counselor | 2280 Wa-821, Yakima, WA 98902 | 2020-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162998 | China Nwachukwu | Pharmacist | Buter-haney Hall, 200 University Pkwy, Yakima, WA 98901 | 2020-07-30 |
| 1760959290 | Conswaylo Ann Fleek | Counselor | 120 S. 3rd Ave., Yakima, WA 98901 | 2018-11-02 |
| 1396212718 | Nancy Fraser | Counselor | 120 S. 3rd Street, Yakima, WA 98901 | 2018-10-24 |
| 1386129021 | John Scott | Student in an Organized Health Care Education/Training Program | Pacific Northwest University of Health Sciences, 111 University Parkway, Suite 202, Yakima, WA 98901 | 2018-09-28 |
| 1679051387 | Toni Christine Fogli | Counselor | 2280 Ste. Rte. 821, Yakima, WA 98901 | 2018-08-03 |
| 1992201982 | Etienne Galbreath | Student in an Organized Health Care Education/Training Program | Butler-haney Hall, 200 University Pkwy, Yakima, WA 98901 | 2018-03-30 |
| 1619490737 | Christine M Armijo | Massage Therapist | 1001 University Parkway, Yakima, WA 98901 | 2017-07-20 |
| 1366970048 | Jose Antonio Mendoza | Dentist | 12 S 8t Hst, Yakima, WA 98901 | 2017-05-25 |
| 1982156501 | David Burkett | Counselor | 315 N. 2nd Street, Yakima, WA 98901 | 2016-10-31 |
| 1114391786 | Nina Reiss | Registered Nurse | 1300 N. 1st St., Yakima, WA 98901 | 2015-11-19 |
| Find all providers in zip 98901 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952918765 | Theresa A Hoisington-yanez | Counselor | 421 S 43rd St, Yakima, WA 98901-1504 | 2020-09-25 |
| 1699391573 | Guadalupe V Bazan Jr. | Counselor | 609 W Logan Ave, Yakima, WA 98902-5553 | 2020-06-17 |
| 1063977692 | Diana Lane Dewey | Counselor | 102 N 48th Ave, Yakima, WA 98908-3134 | 2019-02-07 |
| 1053875625 | Amanda Rose Rodriguez | Counselor | 1410 W Prasch Ave, Yakima, WA 98902-5377 | 2019-01-28 |
| 1720558711 | William Blair Ellis Jr. | Counselor | 611 W A St, Yakima, WA 98902-2605 | 2018-12-03 |
| 1427526524 | Tammy A. Kinter | Counselor | 7610 W Nob Hill Blvd Unit 231, Yakima, WA 98908-1942 | 2018-11-06 |
| 1760959290 | Conswaylo Ann Fleek | Counselor | 120 S. 3rd Ave., Yakima, WA 98901 | 2018-11-02 |
| 1366919359 | Laura Ann Johnston | Counselor | 605 Superior Ln, Yakima, WA 98902-1623 | 2018-10-27 |
| 1396212718 | Nancy Fraser | Counselor | 120 S. 3rd Street, Yakima, WA 98901 | 2018-10-24 |
| 1265916837 | Jasmine Nathaley Barrera-ledezma | Counselor | 2000 W Lincoln Ave Apt 19, Yakima, WA 98902-2477 | 2018-09-19 |
| Find all providers in YAKIMA | ||||
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| 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.