{"npi":"1346535754","type":"NPI-2","status":"active","name":{"display":"Nicolet Counseling LLC","other":[],"organization_name":"NICOLET COUNSELING LLC","authorised_official":"Ronald Nicolet"},"specialty":{"primary_taxonomy":"101YM0800X","primary_taxonomy_description":"Mental Health Counselor","slug":"mental-health-counselor","schema_org_specialty":null,"all":[{"code":"101YA0400X","description":"Addiction Counselor","primary":false,"state":"IN","license":"87000094A"},{"code":"101YM0800X","description":"Mental Health Counselor","primary":true,"state":"IN","license":"39001898A"}]},"addresses":[{"purpose":"LOCATION","street_1":"5709 LIBERTY CT","city":"FORT WAYNE","state":"IN","postal_code":"468044335","country_code":"US","phone":"2604365815"},{"purpose":"MAILING","street_1":"5709 LIBERTY CT","city":"FORT WAYNE","state":"IN","postal_code":"468044335","country_code":"US"}],"license":{"state":"IN","number":"39001898A"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"1","state":"IN","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20120103000196","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"IN","pac_id":"3173799731"}]},"enumeration_date":"2011-06-14","last_updated":"2011-06-14","_meta":{"source":"NPPES","snapshot_date":"2011-06-14","doc_url":"https://findmynpi.com/api"}}