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MS. NICOLE ANNE LIST LCPC
NPI 1093140253
Counselor - Professional in Carlinville, IL

Active since September 06, 2013PECOS EnrolledAccepts Medicare Assignment
320 S LOCUST ST, CARLINVILLE, IL 62626(217) 854-3166(217) 854-9729 Get Directions Write a Review

NPPES record last updated: February 1, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ms. Nicole Anne List Lcpc NPPES

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

MS. NICOLE ANNE LIST LCPC (NPI 1093140253) is an individual professional provider in Carlinville, Illinois, licensed in Illinois (178009320) and active in the NPI registry since September 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1093140253
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMS. NICOLE ANNE LISTCredential: LCPC
Location Address320 S LOCUST STCarlinville, IL 62626-1648
Mailing Address320 S Locust StCarlinville, IL 62626-1648 · (217) 854-3166 · Fax (217) 854-9729
Phone(217) 854-3166
Fax(217) 854-9729
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateSeptember 6, 2013
Last NPPES UpdateFebruary 1, 2023
NPPES CertifiedFebruary 1, 2023
✔ NPI 1093140253 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 IL · 178009320
320 S LOCUST ST, Carlinville, IL 62626
Open in Google Maps ↗

Other Identifiers 1

Medicaid178009320IL

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

Ms. Nicole Anne List Lcpc 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 ID8224575410
PECOS Enrollment IDI20240806001535
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 Nicole List reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Locust Street Resource Center
Same address
Mental Health (Including Community Mental Health Center)
320 SOUTH LOCUST STREET
Carlinville, IL 62626
  • Reassigned Medicare billing, Illinois enrollment
  • 11 clinicians in this Medicare group
NPI 1558456210 (217) 854-3166

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 14

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

RYAN WATTS RN
Registered Nurse
320 S LOCUST ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-3166
CRYSTAL CORSO LPC
Counselor (Mental Health)
320 S LOCUST ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-3166
DR. JUAN M MEDINA MD
Psychiatry & Neurology (Psychiatry)
320 S LOCUST ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-3166
ANNE GREENWALT PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
320 S LOCUST ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-3166
MOLLY A. ONDREY LCPC
Counselor (Mental Health)
320 S LOCUST ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-3166
BRITNEY RENEE NEWMAN LPC
Counselor (Mental Health)
320 S LOCUST ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-3166
TAMRA MARIE TAYLOR LCPC
Counselor (Mental Health)
320 S LOCUST ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-3166
HANNAH MARIE DAVIDSON LCPC
Counselor (Professional)
320 S LOCUST ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-3166

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 List's NPI number?

The NPI number for Nicole List is 1093140253. It was assigned to this individual provider in the NPPES registry on September 6, 2013.

Where is Nicole List located?

Nicole List practices at 320 S Locust St, Carlinville, IL 62626. The listed phone number is (217) 854-3166.

What is Nicole List's specialty?

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

Is Nicole List enrolled in Medicare?

Yes. Nicole List is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Nicole List's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole List reassigns Medicare benefits to Locust Street Resource Center (Carlinville, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole List's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicole List was last updated on February 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.