Active NPI
Kelly Renee Nichol, NCSP
- School Psychologist
- Wilmington, DE
National Provider Identifier
1265915151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 90391
- Practice address
- 2916 Duncan Rd
Wilmington, DE 19808-2319 - Phone
- (302) 636-5681
- NPI assigned
- Sep 7, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 90391 | DE | Primary |
Addresses
Primary practice location
2916 Duncan Rd
Wilmington, DE 19808-2319
Mailing address
1502 Spruce Ave
Wilmington, DE 19805-2148
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 90391 | Other | DE | STATE OF DELAWARE DEPARTMENT OF EDUCATION (INITIAL LICENSE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90391 | DE | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536278400000",
"number": "1265915151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1502 SPRUCE AVE",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198052148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2916 DUNCAN RD",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198082319",
"telephone_number": "302-636-5681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOL",
"first_name": "KELLY",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "NCSP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-07",
"last_updated": "2018-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "DE",
"license": "90391",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF DELAWARE DEPARTMENT OF EDUCATION (INITIAL LICENSE)",
"identifier": "90391",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.