Individual provider Active NPI

Nicola Haddak, LMHC

  • Mental Health Counselor
  • Clearwater, FL
National Provider Identifier
1265592927
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH8832 Issued in FL
Practice address
1938 Soule Rd
Clearwater, FL 33759-1507
Phone
(727) 724-7442
Fax
(727) 288-1111
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH8832 FL Primary

Addresses

Primary practice location

1938 Soule Rd
Clearwater, FL 33759-1507

Mailing address

1938 Soule Road
Clearwater, FL 33759
Phone (727) 726-7442

Other identifiers 1

IdentifierTypeStateIssuer
MH8832OtherFLLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240108005581 FL Practitioner - Mental Health Counselor 0143671735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aandm Psychiatric Services PAGroup PAC ID 9436175403, 10 clinicians

Practice addresses (Care Compare)

1938 Soule Rd
Clearwater, FL 33759-1507
Phone (727) 726-7442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A&M Psychiatric Services PA CurrentSince Jan 1, 2024 Accepting new patients

Locations

1938 Soule Rd
Clearwater, FL 33759
Phone (727) 726-7442

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1265592927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1938 SOULE ROAD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33759",
            "telephone_number": "727-726-7442",
            "fax_number": "727-288-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 SOULE RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337591507",
            "telephone_number": "727-724-7442",
            "fax_number": "727-288-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAK",
        "first_name": "NICOLA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MH8832",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.