Individual provider Active NPI

Nicole Kollanda, LPC

  • Professional Counselor
  • Meriden, CT
National Provider Identifier
1356122204
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7540 Issued in CT
Practice address
87 Warren St
Meriden, CT 06450-3323
Phone
(860) 785-4865
NPI assigned
Oct 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 7540 CT Primary

Addresses

Primary practice location

87 Warren St
Meriden, CT 06450-3323

Mailing address

PO Box 200
Meriden, CT 06450-0200
Phone (860) 785-4865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240813001580 CT Practitioner - Mental Health Counselor 3476091166 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7540CTMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Stokes Counseling Services LLC Professional CurrentSince Aug 1, 2024 Accepting new patients
Jadehopeandhealing LLC Current Accepting new patients

Locations

16 Hillside Ave
Naugatuck, CT 06770
Phone (203) 729-0341

Organizations & group practices 2

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": "1696550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1356122204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064500200",
            "telephone_number": "860-785-4865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 WARREN ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064503323",
            "telephone_number": "860-785-4865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLANDA",
        "first_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-06",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "7540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.