MICHAEL B. NICHOLSON JR. LPCC
NPI 1043457609
Counselor - Professional in Paducah, KY

Q: What is Michael Nicholson's NPI number?

The NPI number for Michael Nicholson is 1043457609. It was assigned to this individual provider in the NPPES registry on January 19, 2009.

Q: What is Michael Nicholson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Michael Nicholson was last updated on October 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 19, 2009PECOS EnrolledAccepts Medicare Assignment

425 BROADWAY ST STE 201, PADUCAH, KY 42001(270) 442-7121 Get Directions Write a Review

NPPES record last updated: October 22, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 19, 2024, Oct 17, 2018 (2 updates tracked since 2018).

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About Michael B. Nicholson Jr. Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL B. NICHOLSON JR. LPCC (NPI 1043457609) is an individual professional provider in Paducah, Kentucky, licensed in Kentucky (162814) and active in the NPI registry since January 2009. He is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1043457609

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMICHAEL B. NICHOLSON JR.Credential: LPCC

Location Address425 BROADWAY ST STE 201Paducah, KY 42001-0713

Mailing Address104 S Front AvePrestonsburg, KY 41653-1614 · (606) 886-8572 · Fax (606) 886-4433

Phone(270) 442-7121

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateJanuary 19, 2009

Last NPPES UpdateOctober 22, 20242 updates tracked since enumeration

NPPES CertifiedOctober 22, 2024

✔ NPI 1043457609 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in KY · 162814

425 BROADWAY ST STE 201, Paducah, KY 42001

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael B. Nicholson Jr. Lpcc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3779029681

PECOS Enrollment IDI20240726001246

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Michael Nicholson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Western Ky Regional Mhmr Board Inc

Same address

Mental Health (Including Community Mental Health Center)

425 BROADWAY, SUITE 201
Paducah, KY 42001

Reassigned Medicare billing, Kentucky enrollment
55 clinicians in this Medicare group

NPI 1841216934 (270) 442-7121

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. ANTHONY B COLLINS LCSW

Social Worker (Clinical)