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NICOLE HENDRICKSON M.A.
NPI 1073064846
Counselor - Mental Health in Los Angeles, CA

Active since October 17, 2016Opted out of Medicare · through Jun 22, 2027
617 S OLIVE ST, SUITE 708, LOS ANGELES, CA 90014(845) 321-5657 Get Directions Write a Review

NPPES record last updated: October 17, 2016. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Nicole Hendrickson M.a. NPPES

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

NICOLE HENDRICKSON M.A. (NPI 1073064846) is an individual mental health provider in Los Angeles, California and active in the NPI registry since October 2016. She has opted out of Medicare through June 22, 2027.

NPPES Registry Identity

NPI1073064846
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameNICOLE HENDRICKSONCredential: M.A.
Location Address617 S OLIVE ST, SUITE 708Los Angeles, CA 90014-1605
Mailing Address617 S Olive St, Suite 708Los Angeles, CA 90014-1605
Phone(845) 321-5657
Sole ProprietorYes
Enumeration DateOctober 17, 2016
✔ NPI 1073064846 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
617 S OLIVE ST, Los Angeles, CA 90014
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Nicole Hendrickson M.a. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 22, 2025 through June 22, 2027.

Opt-Out Effective DateJune 22, 2025
Opt-Out In Effect ThroughJune 22, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 4

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

DR. GITA DONOVAN
Psychologist (Clinical)
617 S OLIVE ST
LOS ANGELES, CA 90014
Los Angeles County (818) 839-0079
ANJU BAGRODIA
Counselor
617 S OLIVE ST
LOS ANGELES, CA 90014
Los Angeles County (213) 430-9080
DR. LELAND SCOTT FRAZIER PHD
Psychologist
617 S OLIVE ST, SUITE 510
LOS ANGELES, CA 90014
Los Angeles County (323) 258-8041
ASIL ALI YASSINE
Student in an Organized Health Care Education/Training Program
617 S OLIVE ST
LOS ANGELES, CA 90014
Los Angeles County (213) 430-9080

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Hendrickson's NPI number?

The NPI number for Nicole Hendrickson is 1073064846. It was assigned to this individual provider in the NPPES registry on October 17, 2016.

Where is Nicole Hendrickson located?

Nicole Hendrickson practices at 617 S Olive St Suite 708, Los Angeles, CA 90014. The listed phone number is (845) 321-5657.

What is Nicole Hendrickson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Nicole Hendrickson enrolled in Medicare?

No. Nicole Hendrickson has opted out of Medicare through June 22, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Nicole Hendrickson was last updated on October 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.