Gregory Carl Nickles , LPC
Counselor - Professional • Kearns, UT
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Gregory Nickles has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Gregory Nickles, LPC was a registered Counselor - Professional practicing in Kearns, UT. Throughout an active medical career spanning 12 years, Gregory Nickles provided care at the practice location at 3809 W 6200 S until profile deactivation on 2017-05-31.
Practice Location & Contact Primary Location
3809 W 6200 S
Kearns, UT 841183725
Specialty Benchmarks & Practice Insights
Comparative analytics for Counselor - Professional in Kearns, UT
Practicing in Kearns, UT (520 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 101YP2500X
Definition to come...
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Community Health Worker
Psychologist - School
MS(CLINICALPSYCH)
Psychologist - Clinical
Doctor of Philosophy (Ph.D.)
Psychologist - School
Registered Nurse - Psychiatric/Mental Health, Child & Adolescent
Registered Nurse
Social Worker
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on May 31, 2017
NPI status registered as active in NPPES database
Registered at 3809 W 6200 S, KEARNS, UT 841183725 (Tel: 8019634200)
Registered at 3536 MASON VISTA WAY, MAGNA, UT 840443505 (Tel: 8012506959)
Recorded as GREGORY NICKLES, LPC
Counselor (License #304614-6004 in UT)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
3536 Mason Vista Way
Magna, UT 840443505
Phone: 8012506959
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