MEDICARE: JOHN W NICKISSON LMSW, CAADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	2-00774	MI
2	1041C0700X	Clinical Social Worker	6801087785	MI

General Provider Information

NPI Number	:	1184751521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN W NICKISSON LMSW, CAADC

Provider Business Mailing Address
First Line	:	18554 NORTHLAND DR
Second Line	:
City	:	BIG RAPIDS
State	:	MI
Zip	:	49307-8788
Country	:	US
Telephone Number	:	231-349-6111
Fax Number	:

Provider Business Practice Location Address
First Line	:	18554 NORTHLAND DR
Second Line	:
City	:	BIG RAPIDS
State	:	MI
Zip	:	49307-8788
Country	:	US
Telephone Number	:	231-349-6111
Fax Number	:	231-796-6280

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	11/06/2012

Similar Medicare Providers

1881738276 — DR. SUSAN H FOWLER PSYD
Practice Location Address:

18554 NORTHLAND DR
BIG RAPIDS, MI
49307-8788

Practice Phone: 231-796-3339
Practice Fax:

1821219882 — MRS. BONNIE SUE CRIPE PHD LMSW ACSW DAPA
Practice Location Address:

18554 NORTHLAND DR
BIG RAPIDS, MI
49307-8788

Practice Phone: 231-592-8090
Practice Fax: 231-796-3184

1821299769 — MS. THERESA ANN RUELLE LMSW
Practice Location Address:

18554 NORTHLAND DR
BIG RAPIDS, MI
49307-8788

Practice Phone: 231-250-4335
Practice Fax: 231-796-5450

1780110551 — A TURNING POINT COUNSELING SERVICES
Practice Location Address:

18554 NORTHLAND DR STE B
BIG RAPIDS, MI
49307-8788

Practice Phone: 231-287-2049
Practice Fax:

1063171346 — CHRIS PAHOLAK CADC
Practice Location Address:

18554 NORTHLAND DR
BIG RAPIDS, MI
49307-8788

Practice Phone: 231-580-6355
Practice Fax:

1366391393 — JORDAN MICHAEL PRICE FNP-BC
Practice Location Address:

20095 GILBERT RD STE B
BIG RAPIDS, MI
49307-2366

Practice Phone: 231-592-1360
Practice Fax: 231-592-1361

Directions to “ JOHN W NICKISSON LMSW, CAADC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.