Individual provider Active NPI

Nicole Newberry

  • Professional Counselor
  • Nottingham, MD
National Provider Identifier
1245978485
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LGP12861 Issued in MD
Practice address
5022 Campbell Blvd Ste L-M
Nottingham, MD 21236-4969
Phone
(443) 442-1568
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC17086 MD
Professional Counselor 101YP2500X
Professional Counselor 101YP2500X LGP12861 MD Primary

Addresses

Primary practice location

5022 Campbell Blvd Ste L-M
Nottingham, MD 21236-4969

Mailing address

5022 Campbell Blvd Ste L-M
Nottingham, MD 21236-4969
Phone (443) 442-1568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251114001115 MD Practitioner - Mental Health Counselor 6800387192

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspire Wellness Center IncGroup PAC ID 2961685706, 41 clinicians

Practice addresses (Care Compare)

5022 Campbell Blvd
Suite L M
Nottingham, MD 21236-4969
Phone (443) 442-1568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC17086MDMDProfessional Counselor
LGP12861MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Wellness Center, Inc. CurrentSince Oct 10, 2025 Accepting new patients

Locations

5022 Campbell Blvd
Ste Lm
Nottingham, MD 21236
Phone (443) 442-1568

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1245978485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5022 CAMPBELL BLVD STE L-M",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364969",
            "telephone_number": "443-442-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5022 CAMPBELL BLVD STE L-M",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364969",
            "telephone_number": "443-442-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERRY",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC17086",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP12861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nottingham, MD

Sources for this page

Verify at the official NPI Registry.