Active NPI
Nicole C Winters, LICSW, PSYD
- Clinical Psychologist
- Marysville, WA
National Provider Identifier
1306075940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60195906
- Practice address
- 5019 Grove St Ste 102
Marysville, WA 98270-4491 - Phone
- (425) 387-2113
- NPI assigned
- Jul 2, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY60195906 | WA | Primary |
| Clinical Social Worker | 1041C0700X | LW60059975 | WA |
Addresses
Primary practice location
5019 Grove St Ste 102
Marysville, WA 98270-4491
Mailing address
5019 Grove St Ste 102
Marysville, WA 98270-4491
Phone (425) 387-2113
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY60195906 | WA | MD | Clinical Psychologist |
| LW60059975 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334102400000",
"number": "1306075940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5019 GROVE ST STE 102",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982704491",
"telephone_number": "425-387-2113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5019 GROVE ST STE 102",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982704491",
"telephone_number": "425-387-2113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINTERS",
"first_name": "NICOLE",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "LICSW, PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-02",
"last_updated": "2012-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60195906",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW60059975",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.