Dr Nicoles Online Therapy, Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

DR NICOLES ONLINE THERAPY, INC

Doing business as

Mommas Pedestal

Practice address

2208 Skyline Dr
West Bend, WI 53090-1143

Phone

(414) 232-7277

NPI assigned

Sep 9, 2026

Last updated

Sep 9, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Nicole Smith, PSYDNPI 1215206552

Title

Owner

Phone

(414) 232-7277

Specialties & licenses 1

Addresses

Other names 1

• Mommas Pedestal Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole Lynn Smith, PSY.D., L.P.

  • Clinical Child & Adolescent Psychologist
  • Minnetonka, MN
  • NPI 1215206552
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1788912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1033029491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 434",
            "city": "SLINGER",
            "state": "WI",
            "postal_code": "530860434",
            "telephone_number": "414-232-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 SKYLINE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530901143",
            "telephone_number": "414-232-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR NICOLES ONLINE THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-09",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-232-7277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mommas Pedestal",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holly Dow
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• Jaime L Doyle, OTR
• Laura Doyle, LPN
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• Sara Drain, APRN-CRNA
• Tracy Drake, M.D.
• William Drankiewicz, PSY.D

• Psychologist in West Bend, WI
• Providers in West Bend, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.