Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Michael R Nicholson, CSACCSIT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1619101847

Mr. Michael R Nicholson, CSACCSIT is a Mental Health Counselor in Hales Corners, Wisconsin. Qualified in 2015, 11 years ago. Offers telehealth. Licensed in Wisconsin.

Years since qualifying
11
Licensed in
WI
In the registry since
2009

Practice location Address checks out

10940 W Forest Home Ave
Hales Corners, WI 53130-2516
Phone: (262) 278-4462
Fax: (815) 387-2569
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 15466-132 (WI)

Record details

NPI number1619101847
Entity typeIndividual (Type 1)
GenderMale
Credentials CSACCSIT
Sole proprietorNo
NPI enumeratedMay 1, 2009
Last updated in NPPESApril 26, 2016
Mailing address1021 N Mulford Rd, Rockford, IL 61107-3877

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

Other providers in Hales Corners