Mr Michael R Nicholson, CSAC CSIT in Hales Corners, WI

Mr Michael R Nicholson, CSAC CSIT is a medicare enrolled "Counselor - Addiction (substance Use Disorder)" provider in Hales Corners, Wisconsin. His current practice location is 10940 W Forest Home Ave, Hales Corners, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (262) 278-4462.

Mr Michael R Nicholson is licensed to practice in Wisconsin (license number 15466-132) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1619101847.

Contact Information

	Mr Michael R Nicholson, CSAC CSIT
	10940 W Forest Home Ave, Hales Corners, WI 53130-2516
	(262) 278-4462
	(815) 387-2569

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Michael R Nicholson
Gender	Male
Speciality	Counselor - Addiction (substance Use Disorder)
Location	10940 W Forest Home Ave, Hales Corners, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1619101847
Provider Enumeration Date: 05/01/2009
Last Update Date: 04/26/2016

Medicare PECOS Information:

PECOS PAC ID: 7113379090
Enrollment ID: I20240116003216

Medical Identifiers

Medical identifiers for Mr Michael R Nicholson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1619101847	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	15466-132 (Wisconsin)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Michael R Nicholson allows following entities to bill medicare on his behalf.

Entity Name	Red Oak Counseling Ltd
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1609890391 PECOS PAC ID: 5294704334 Enrollment ID: O20040927000490

Entity Name	Optum Behavioral Care Of Colorado, P.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1487424826 PECOS PAC ID: 0941648463 Enrollment ID: O20240429000918

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Michael R Nicholson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Michael R Nicholson, CSAC CSIT 1021 N Mulford Rd, Rockford, IL 61107-3877 Ph: (815) 391-5600	Mr Michael R Nicholson, CSAC CSIT 10940 W Forest Home Ave, Hales Corners, WI 53130-2516 Ph: (262) 278-4462

Reviews and Comments

Counselor in Hales Corners, WI

Brianna N Kirnbauer, B.A PSYCHOLOGY Counselor Medicare: Not Enrolled in Medicare Practice Location: 5250 S 108th St, Hales Corners, WI 53130 Phone: 414-296-1730
Mrs. Barbara Josephine Baer, MA LMFT LPC LCSW Counselor Medicare: Medicare Enrolled Practice Location: 5300 S 108th St, Recovery Point Sc Suite 12b, Hales Corners, WI 53130 Phone: 414-529-2591 Fax: 414-529-2669
Demitra Hahnfeld, MS, LPC, CRC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10185 W Plum Tree Cir Apt 205, Hales Corners, WI 53130 Phone: 414-378-2077
Sandra M Vandomelen, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 9415 W Forest Home Ave, Suite #1, Hales Corners, WI 53130 Phone: 414-427-4884
Andrew Moon, APSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 10940 W Forest Home Ave, Hales Corners, WI 53130 Phone: 262-278-4462 Fax: 815-387-2569
Marianne Faith Skrobiak, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5300 S 108th St, Suite 12b, Hales Corners, WI 53130 Phone: 414-529-2591 Fax: 414-529-2669
Lawrence Vernon Dulek, RADC I Counselor Medicare: Not Enrolled in Medicare Practice Location: 9415 West Forest Home Avenue, Suite #108, Hales Corners, WI 53130 Phone: 414-427-4884 Fax: 414-427-4889

Mr Michael R Nicholson, CSAC CSIT - Medicare Counselor in Hales Corners, WI