Individual provider Active NPI

Nicole Latasha Shell, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • White Marsh, MD
National Provider Identifier
1265056774
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R192533 Issued in MD
Practice address
5430 Campbell Blvd Ste 107
White Marsh, MD 21162-5503
Phone
(443) 720-3902
Fax
(443) 720-3916
NPI assigned
May 31, 2020
Last updated
Jan 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R192533 MD Primary

Addresses

Primary practice location

5430 Campbell Blvd Ste 107
White Marsh, MD 21162-5503

Mailing address

1105 N Point Blvd Ste 310
Baltimore, MD 21224-3472
Phone (410) 800-6186

Other practice location 1

1105 N Point Blvd Ste 310
Baltimore, MD 21224-3472
Phone (443) 943-0007

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260209003520 MD Practitioner - Nurse Practitioner 1052890118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1105 N Point Blvd
Suite 310
Baltimore, MD 21224-3472

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R192533MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nicole Shell Psychiatry, LLC Psychiatric/Mental Health Current Accepting new patients
Restoring Minds Behavioral Health Services, LLC CurrentSince Nov 18, 2025 Accepting new patients
Restoring Minds Behavioral Health Services, LLC Psychiatric/Mental Health Past Accepting new patients
Restoring Minds Behavioral Health Services, LLC Psychiatric/Mental Health Past Accepting new patients
Restoring Minds Behavioral Health Services, LLC Psychiatric/Mental Health Past Accepting new patients

Locations

1105 N Point Blvd
Ste 310
Baltimore, MD 21224
Phone (410) 800-6186

5430 Campbell Blvd
Ste 107
White Marsh, MD 21162
Phone (443) 300-6757

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1590883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1265056774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 N POINT BLVD STE 310",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243472",
            "telephone_number": "410-800-6186",
            "fax_number": "443-943-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 CAMPBELL BLVD STE 107",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211625503",
            "telephone_number": "443-720-3902",
            "fax_number": "443-720-3916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 N Point Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212243472",
            "country_code": "US",
            "telephone_number": "443-943-0007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELL",
        "first_name": "NICOLE",
        "middle_name": "LATASHA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-31",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R192533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Marsh, MD

Sources for this page

Verify at the official NPI Registry.