1. Home
  2. Directory
  3. Wisconsin
  4. Hales Corners
  5. Counselor
  6. NPI Profile

MR. MICHAEL R NICHOLSON CSAC CSIT
NPI 1619101847
Counselor - Addiction (Substance Use Disorder) in Hales Corners, WI

Active since May 01, 2009PECOS Enrolled
10940 W FOREST HOME AVE, HALES CORNERS, WI 53130(262) 278-4462(815) 387-2569 Get Directions Write a Review

NPPES record last updated: April 26, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Michael R Nicholson Csac Csit NPPES

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

MR. MICHAEL R NICHOLSON CSAC CSIT (NPI 1619101847) is an individual addiction (substance use disorder) provider in Hales Corners, Wisconsin, licensed in Wisconsin (15466-132) and active in the NPI registry since May 2009. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1619101847
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. MICHAEL R NICHOLSONCredential: CSAC CSIT
Location Address10940 W FOREST HOME AVEHales Corners, WI 53130-2516
Mailing Address1021 N Mulford RdRockford, IL 61107-3877 · (815) 391-5600 · Fax (815) 316-4726
Phone(262) 278-4462
Fax(815) 387-2569
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMay 1, 2009
Last NPPES UpdateApril 26, 2016
✔ NPI 1619101847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in WI · 15466-132
10940 W FOREST HOME AVE, Hales Corners, WI 53130
Open in Google Maps ↗

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Michael R Nicholson Csac Csit is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7113379090
PECOS Enrollment IDI20240116003216
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.

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 Michael Nicholson's NPI number?

The NPI number for Michael Nicholson is 1619101847. It was assigned to this individual provider in the NPPES registry on May 1, 2009.

Where is Michael Nicholson located?

Michael Nicholson practices at 10940 W Forest Home Ave, Hales Corners, WI 53130. The listed phone number is (262) 278-4462.

What is Michael Nicholson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Michael Nicholson enrolled in Medicare?

Yes. Michael Nicholson is registered in the Medicare PECOS enrollment system.

What insurance does Michael Nicholson accept?

Health plans from Anthem Blue Cross and Blue Shield, Medica, Network Health, Providence Health Plan and Quartz and 1 other insurer list Michael Nicholson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Michael Nicholson was last updated on April 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.