Individual provider Active NPI

Nicola Pinto, LCSW. PMHNP

  • Psychiatric/Mental Health Registered Nurse
  • Decatur, GA
National Provider Identifier
1356748636
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
300926 Issued in GA
Practice address
2711 Irvin Way Ste 211
Decatur, GA 30030-1724
Phone
(404) 501-0001
Fax
(404) 501-0023
NPI assigned
Dec 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05599500 NJ
Psychiatric/Mental Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0808X 300926 GA Primary

Addresses

Primary practice location

2711 Irvin Way Ste 211
Decatur, GA 30030-1724

Mailing address

1201 Baywood Cir
Morrow, GA 30260-2194
Phone (973) 803-3763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20250311001390 GA Practitioner - Nurse Practitioner 9234650938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05599500NJMDClinical Social Worker
300926GAMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Advancement Services Past Accepting new patients

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": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1356748636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 BAYWOOD CIR",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602194",
            "telephone_number": "973-803-3763",
            "fax_number": "877-804-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 IRVIN WAY STE 211",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301724",
            "telephone_number": "404-501-0001",
            "fax_number": "404-501-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINTO",
        "first_name": "NICOLA",
        "name_prefix": "Ms.",
        "credential": "LCSW. PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-02",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05599500",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "GA",
            "license": "300926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.