Nicole Lavertue, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS017830 Issued in PA

Practice address

8638 Route 104 Ste 104
Mount Pleasant Mills, PA 17853-8752

Phone

(717) 856-0220

NPI assigned

Aug 8, 2018

Last updated

Nov 23, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Two Trails Mental Health and Wellness Center, LLC

  dba Dr. Danielle M. Mink

  • Psychologist
  • Mt Pleasant Mills, PA
  • NPI 1376902486
  NPD (past)

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542931200000",
    "number": "1053890384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8638 ROUTE 104 STE 10",
            "city": "MOUNT PLEASANT MILLS",
            "state": "PA",
            "postal_code": "178538753",
            "telephone_number": "717-856-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8638 ROUTE 104 STE 104",
            "city": "MOUNT PLEASANT MILLS",
            "state": "PA",
            "postal_code": "178538752",
            "telephone_number": "717-856-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVERTUE",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Kay Bryner, LSW
• Zebulin Jacob Bryner, LSW
• Tammi Ann Burns, PA-C
• Tracy Anne Ericson, LCSW
• Fremont Fire Department
• Teresa Michele Longacre, PTA
• Tara Alicia Paige
• Erica Rhoads, MS, LPC
• Rhythms of Grace Christian Counseling LLC
• Domenick Nicholas Ronco, DO

• Clinical Psychologist in Mt Pleasant Mills, PA
• Providers in Mt Pleasant Mills, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2018; 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.