Nicole Alexandra Traub, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN02648 Issued in RI

Practice address

1485 S County TRL Unit 107
East Greenwich, RI 02818-1771

Phone

(401) 785-0040

NPI assigned

Jul 23, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in RI

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Child and Family Psychiatry, Inc.Group PAC ID 5294173464, 90 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.nicoletraub@151046.advancedmd-direct.com
• FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA

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.

• Child and Family Psychiatry, Inc.

  dba LifeStance Health

  • Psychiatry Physician
  • Warwick, RI
  • NPI 1760863229
  Medicare reassignment Care Compare group NPD
• Thundermist Health Center

  • Federally Qualified Health Center (FQHC)
  • Wakefield, RI
  • NPI 1700041001
  Medicare reassignment NPD
• Thundermist Health Center

  • Federally Qualified Health Center (FQHC)
  • Narragansett, RI
  • NPI 1265190292
  NPD
• Thundermist Health Center

  • Federally Qualified Health Center (FQHC)
  • West Warwick, RI
  • NPI 1376708560
  NPD

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1336452077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 S COUNTY TRL UNIT 107",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028181771",
            "telephone_number": "401-785-0040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 River St",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028793214",
            "country_code": "US",
            "telephone_number": "401-783-5646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAUB",
        "first_name": "NICOLE",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-23",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP3625",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "AP3626",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP3625",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "APRN02648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336452077",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "U400770761",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.thundermisthealth.org",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "1 River St",
            "city": "Wakefield",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028793214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Frank J Toce III, PHARM.D.
• Valerie Ann Tokarz, D.O., FAAD
• Pia Torres, DVM
• Town of East Greenwich
• Tranquil Rhodes Counseling
• Treat Yourself Therapy LLC
• Flora Treger, MD
• Margaret Ruth Trippel, LCDP ATC
• Tru-Care Physical Therapy Inc.
• Philip M. Trupiano, DO

• Psychiatric/Mental Health Nurse Practitioner in East Greenwich, RI
• Providers in East Greenwich, RI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.