Nickole Brick, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

004862 Issued in CT

Practice address

225 Amity Rd
Woodbridge, CT 06525-2206

Phone

(203) 387-0076

NPI assigned

Sep 24, 2016

Last updated

Sep 24, 2016By 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

Enrolled in MI

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Legacy Healthcare Services Inc

  • Physical Therapist
  • Bay City, MI
  • NPI 1942829064

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1474675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474675200000",
    "number": "1073062667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 AMITY RD",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 AMITY RD",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252206",
            "telephone_number": "203-387-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICK",
        "first_name": "NICKOLE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-24",
        "last_updated": "2016-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "004862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Nicole Blanck, MS, CCC/SLP
• Sandra P Boltax-Stern, MD
• Kyle Branday, MSPT
• Breakthrough Therapeutic Services
• Lindsay Jane Brelsford, SLP
• Bridges to Success LLC
• Gail Briggs-Malanson, PT
• Beth Brownstein
• Amanda Bruce, MS, OTR/L
• Nita Ketan Bulsara, RPH

• Speech-Language Pathologist in Woodbridge, CT
• Providers in Woodbridge, CT by specialty
• Speech-Language Pathologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.