NICHOLE DECORAH LPC-IT
NPI 1154894848
Counselor - Professional in Portage, WI

Q: What is Nichole Decorah's NPI number?

The NPI number for Nichole Decorah is 1154894848. It was assigned to this individual provider in the NPPES registry on January 6, 2019.

Q: What is Nichole Decorah'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 Nichole Decorah was last updated on August 21, 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 06, 2019PECOS EnrolledAccepts Medicare Assignment

1508 NEW PINERY RD, PORTAGE, WI 53901(608) 745-4900 Get Directions Write a Review

NPPES record last updated: August 21, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 21, 2024, Nov 23, 2021, Jan 6, 2019 (3 updates tracked since 2019).

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About Nichole Decorah Lpc-it NPPES

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

NICHOLE DECORAH LPC-IT (NPI 1154894848) is an individual professional provider in Portage, Wisconsin, licensed in Wisconsin (5176-226) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Madison, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1154894848

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameNICHOLE DECORAHCredential: LPC-IT

Location Address1508 NEW PINERY RDPortage, WI 53901-1312

Mailing Address532 Laurel StReedsburg, WI 53959-1231 · (608) 566-5187

Phone(608) 745-4900

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateJanuary 6, 2019

Last NPPES UpdateAugust 21, 20243 updates tracked since enumeration

NPPES CertifiedAugust 21, 2024

✔ NPI 1154894848 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 WI · 5176-226

1508 NEW PINERY RD, Portage, WI 53901

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Secondary Practice Location 1

Location 1752 N High Point RdMadison, WI 53717-2236 · Phone (608) 824-4000 · Fax (608) 824-4938

Other Identifiers 1

Medicaid1154894848WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nichole Decorah Lpc-it 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 ID1456890912

PECOS Enrollment IDI20240828001602

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.

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.

MELISSA TRAGO

Counselor (Professional)