Shana Nicole Nichols, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R213445 Issued in MD

Practice address

8338 Veterans Hwy Ste 204a
Millersville, MD 21108-2603

Phone

(410) 705-4422

Fax

(205) 855-0617

NPI assigned

Jan 2, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Spiritual Healing

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
  • NPI 1003502337
  Medicare reassignment NPD
• Toller Enterprises LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
  • NPI 1821697533
  Medicare reassignment NPD
• Spiritual Healing

  • Pain Management Registered Nurse
  • Baltimore, MD
  • NPI 1982399218
  NPD
• State of Mind Health & Wellness, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lanham, MD
  • NPI 1932862000
  NPD
• Toller Enterprises LLC

  • Pain Management Registered Nurse
  • Baltimore, MD
  • NPI 1821694084
  NPD

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

{
    "created_epoch": "1672617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1033822317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7933 ANNAPOLIS RD # 1054",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207061309",
            "telephone_number": "410-705-4422",
            "fax_number": "205-855-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8338 VETERANS HWY STE 204A",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211082603",
            "telephone_number": "410-705-4422",
            "fax_number": "205-855-0617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2232 E Monument St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212052431",
            "country_code": "US",
            "telephone_number": "667-207-3552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "SHANA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-02",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R213445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Nenninger, BCBA
• Neuropsychological Consulting Services
• New Genesis Consulting Services
• Nexus Health Center Inc
• Duy Nguyen, PHARMD
• Cearra Theresa Nicholson
• Rebecca Niner, LGPC
• Brianne Nolan, LCPC
• Christopher Novak, DPT
• Martin P. Nowakowski, D.D.S.

• Psychiatric/Mental Health Nurse Practitioner in Millersville, MD
• Providers in Millersville, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.