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MS. CAMILLE NICHOLS MFT
NPI 1073657656
Marriage & Family Therapist in Berkeley, CA

Active since February 16, 2007Opted out of Medicare · through Jan 4, 2028
1314 CORNELL AVE, BERKELEY, CA 94702(510) 526-3292(510) 526-3755 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ms. Camille Nichols Mft NPPES

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

MS. CAMILLE NICHOLS MFT (NPI 1073657656) is an individual marriage & family therapist in Berkeley, California, licensed in California (MFT35621) and active in the NPI registry since February 2007. She has opted out of Medicare through January 4, 2028.

NPPES Registry Identity

NPI1073657656
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameMS. CAMILLE NICHOLSCredential: MFT
Location Address1314 CORNELL AVEBerkeley, CA 94702-1010
Mailing Address1314 Cornell AveBerkeley, CA 94702-1010 · (510) 526-3292 · Fax (510) 526-3755
Phone(510) 526-3292
Fax(510) 526-3755
Sole ProprietorYes
Enumeration DateFebruary 16, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1073657656 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · MFT35621
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
1314 CORNELL AVE, Berkeley, CA 94702
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Ms. Camille Nichols Mft 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 January 4, 2024 through January 4, 2028.

Opt-Out Effective DateJanuary 4, 2024
Opt-Out In Effect ThroughJanuary 4, 2028Opt-out affidavits renew automatically every two years unless cancelled

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 Camille Nichols's NPI number?

The NPI number for Camille Nichols is 1073657656. It was assigned to this individual provider in the NPPES registry on February 16, 2007.

Where is Camille Nichols located?

Camille Nichols practices at 1314 Cornell Ave, Berkeley, CA 94702. The listed phone number is (510) 526-3292.

What is Camille Nichols's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Camille Nichols enrolled in Medicare?

No. Camille Nichols has opted out of Medicare through January 4, 2028. 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 Camille Nichols was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.