A SPACE FOR NICHOLAS LLC — NPI 1922823194 (Licensed & Credentialed Community/Behavioral Health in DURHAM, NC)

CMS-1500 Box 24J / 33a • NPI

1922823194

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

251S00000X

Licensed & Credentialed Community/Behavioral Health

Box 32 Service Location & ZIP+4

2310 S MIAMI BLVD STE 141, DURHAM, NC, 27703-4900

✓ 9-Digit EDI 837 ZIP+4 (27703-4900)

Practice Phone & Referral Fax

(919) 228-8026

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1922823194 (A SPACE FOR NICHOLAS LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1922823194` (NPI-2 Organization / Facility)
Provider / Legal Name	A SPACE FOR NICHOLAS LLC
Plain-English Specialty	Licensed & Credentialed Community/Behavioral Health NUCC Code: `251S00000X` (Community/Behavioral Health)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2310 S MIAMI BLVD STE 141, DURHAM, NC, 27703-4900
Practice Telephone / Fax	Tel: (919) 228-8026
Administrative Mailing Address	6409 FAYETTEVILLE RD STE 120 #185, DURHAM, NC, 27713
Enumeration & Last Sync	Enumerated: 2024-11-21 \| CMS Record Updated: 2025-01-26
Authorized Official	DAKENA STEWART (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2310 S MIAMI BLVD STE 141, DURHAM, NC, 27703-4900

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Plain-English Taxonomy & CMS Crosswalk (251S00000X)

What Does Taxonomy Code 251S00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 251S00000X translates to:
"Licensed & Credentialed Community/Behavioral Health"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Community/Behavioral Health for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (A SPACE FOR NICHOLAS LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103K00000X` — Behavior Analyst Plain English: Licensed & Credentialed Behavior Analyst	State: N/A \| License: `Verified` \| Primary: Secondary
`104100000X` — Social Worker Plain English: Licensed & Credentialed Social Worker	State: N/A \| License: `Verified` \| Primary: Secondary
`1041C0700X` — Social Worker, Clinical Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical	State: N/A \| License: `Verified` \| Primary: Secondary
`106E00000X` — Assistant Behavior Analyst Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Assistant Behavior Analyst	State: N/A \| License: `Verified` \| Primary: Secondary
`106S00000X` — Behavior Technician Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Technician	State: N/A \| License: `Verified` \| Primary: Secondary
`208000000X` — Pediatrics Plain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)	State: N/A \| License: `Verified` \| Primary: Secondary
`225X00000X` — Occupational Therapist Plain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab)	State: N/A \| License: `Verified` \| Primary: Secondary
`235Z00000X` — Speech-Language Pathologist, Plain English: Licensed & Credentialed Speech, Language and Hearing Service Providers	State: N/A \| License: `Verified` \| Primary: Secondary
`251S00000X` — Community/Behavioral Health Plain English: Licensed & Credentialed Community/Behavioral Health	State: N/A \| License: `Verified` \| Primary: Yes (Primary)
`261QH0100X` — Clinic/Center, Health Services Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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A SPACE FOR NICHOLAS LLC (NPI #1922823194)