MCKENZIE NICKERSON LPC NPI 1043807456

NPI Information

  • NPI: 1043807456
  • Provider Name: MCKENZIE NICKERSON, LPC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1423 N JEFFERSON AVE
    3RD FLOOR
    SPRINGFIELD, MO
    ZIP 65802
  • Phone: (417) 761-5000

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NPI Details

Mckenzie Nickerson, LPC is a professional counselor in Springfield, MO. Mckenzie Nickerson, LPC NPI is 1043807456. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1423 N JEFFERSON AVE
3RD FLOOR
SPRINGFIELD, MO
ZIP 65802
Phone: (417) 761-5000
Fax: (417) 761-5011

The NPI 1043807456 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 12/31/2020 and was last updated on 10/10/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessional2021005306MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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