DR. MAUREEN TARA NICKERSON PSYD
NPI 1578130274
Psychologist - Clinical in Medical Lake, WA

Q: What is Maureen Nickerson's NPI number?

The NPI number for Maureen Nickerson is 1578130274. It was assigned to this individual provider in the NPPES registry on June 10, 2021.

Q: What is Maureen Nickerson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Maureen Nickerson was last updated on June 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 10, 2021PECOS Enrolled

850 W. MAPLE ST., MEDICAL LAKE, WA 99022(509) 565-4000 Get Directions Write a Review

NPPES record last updated: June 10, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Dr. Maureen Tara Nickerson Psyd NPPES

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

DR. MAUREEN TARA NICKERSON PSYD (NPI 1578130274) is an individual clinical provider in Medical Lake, Washington, licensed in Washington (PY60778414) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1578130274

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. MAUREEN TARA NICKERSONCredential: PSYD

Location Address850 W. MAPLE ST.Medical Lake, WA 99022

Mailing AddressP.o. Box 800, 850 W. Maple St.Medical Lake, WA 99022

Phone(509) 565-4000

Sole ProprietorNo

Enumeration DateJune 10, 2021

NPPES CertifiedJune 10, 2021

✔ NPI 1578130274 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in WA · PY60778414

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

850 W. MAPLE ST., Medical Lake, WA 99022

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Maureen Tara Nickerson Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99022 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$172.80 typical visit price

range $57.27 – $172.80

Typical copayment $43.20 (range $14.31 – $43.20)

Most-billed visit code 99205

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

LISA MATHEWS

Psychologist

850 W. MAPLE ST.
MEDICAL LAKE, WA 99022

Spokane County (509) 565-4000

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 Maureen Nickerson's NPI number?

The NPI number for Maureen Nickerson is 1578130274. It was assigned to this individual provider in the NPPES registry on June 10, 2021.

Where is Maureen Nickerson located?

Maureen Nickerson practices at 850 W. Maple St., Medical Lake, WA 99022. The listed phone number is (509) 565-4000.

What is Maureen Nickerson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Maureen Nickerson enrolled in Medicare?

Yes. Maureen Nickerson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Maureen Nickerson was last updated on June 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.