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LEIGH-DEMETRA NICKLOW LADC, SC-C
NPI 1831065895
Student in an Organized Health Care Education/Training Program in Center City, MN

Active since October 15, 2025
15251 PLEASANT VALLEY RD, CENTER CITY, MN 55012(651) 213-4075(651) 213-4888 Get Directions Write a Review

NPPES record last updated: October 15, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Leigh-demetra Nicklow Ladc, Sc-c NPPES

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

LEIGH-DEMETRA NICKLOW LADC, SC-C (NPI 1831065895) is an individual student in an organized health care education/training program in Center City, Minnesota, licensed in Minnesota (306810) and active in the NPI registry since October 2025.

NPPES Registry Identity

NPI1831065895
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameLEIGH-DEMETRA NICKLOWCredential: LADC, SC-C
Location Address15251 PLEASANT VALLEY RDCenter City, MN 55012-9640
Mailing Address15251 Pleasant Valley RdCenter City, MN 55012-9640 · (651) 213-4075 · Fax (651) 213-4888
Phone(651) 213-4075
Fax(651) 213-4888
Sole ProprietorNo
Enumeration DateOctober 15, 2025
NPPES CertifiedOctober 15, 2025
✔ NPI 1831065895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in MN · 306810
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
15251 PLEASANT VALLEY RD, Center City, MN 55012
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Other Providers at the Same Location NPPES 20

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

HOLLY LEIGH PEDERSON
Student in an Organized Health Care Education/Training Program
15251 PLEASANT VALLEY RD
CENTER CITY, MN 55012
Chisago County (800) 257-7800
MS. TARIRO LYNETTE CHIINZE PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
15251 PLEASANT VALLEY RD
CENTER CITY, MN 55012
Chisago County (651) 213-4779
DANIEL SPAULDING
Counselor (Addiction (Substance Use Disorder))
15251 PLEASANT VALLEY RD
CENTER CITY, MN 55012
Chisago County (800) 257-7800
ANNALYSE HAAGENSON
Counselor (Mental Health)
15251 PLEASANT VALLEY RD
CENTER CITY, MN 55012
Chisago County (651) 213-4747
LORI L MACK RD
Dietitian, Registered
15251 PLEASANT VALLEY RD
CENTER CITY, MN 55012
Chisago County (651) 213-4407
THAD MICHAEL JENSEN LADC, LPCC, LMHC
Counselor (Mental Health)
15251 PLEASANT VALLEY RD
CENTER CITY, MN 55012
Chisago County (651) 213-4779
KATHRYN M MANNING MD
Psychiatry & Neurology (Psychiatry)
15251 PLEASANT VALLEY RD
CENTER CITY, MN 55012
Chisago County (651) 213-4525
KABITA ROY PSYD RN
Psychologist (Addiction (Substance Use Disorder))
15251 PLEASANT VALLEY RD
CENTER CITY, MN 55012
Chisago County (651) 213-4184

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 Leigh-demetra Nicklow's NPI number?

The NPI number for Leigh-demetra Nicklow is 1831065895. It was assigned to this individual provider in the NPPES registry on October 15, 2025.

Where is Leigh-demetra Nicklow located?

Leigh-demetra Nicklow practices at 15251 Pleasant Valley Rd, Center City, MN 55012. The listed phone number is (651) 213-4075.

What is Leigh-demetra Nicklow's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Leigh-demetra Nicklow was last updated on October 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.