Active NPI
Natalie Olivia Nordlund
- Psychologist
- Victor, NY
National Provider Identifier
1366114332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 5239-57
- Practice address
- 6539 Anthony Dr Ste a
Victor, NY 14564-1441 - Phone
- (585) 398-8835
- Fax
- (585) 398-7376
- NPI assigned
- Sep 29, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 4372491 | NY | |
| School Psychologist | 103TS0200X | 3001026894 | WI | |
| Psychologist | 103T00000X | 5239-57 | WI | Primary |
Addresses
Primary practice location
6539 Anthony Dr Ste a
Victor, NY 14564-1441
Mailing address
6539 Anthony Dr Ste a
Victor, NY 14564-1441
Phone (585) 398-8835
Other practice location 1
1720 W Florist Ave Ste 125
Glendale, WI 53209-3862
Phone (414) 247-0801
Other practice location 2
242 W Main St Apt 408
Rochester, NY 14614-1147
Phone (515) 571-0848
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 |
|---|---|---|---|
| 5239-57 | WI | MD | Psychologist |
| 4372491 | NY | MD | School Psychologist |
| 3001026894 | WI | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sebastian Family Psycholgy Practice | Past | Accepting new patients | |
| Sebastian Family Psycholgy Practice | Past | Accepting new patients |
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.
-
- Professional Counselor
- Glendale, WI
- NPI 1124441373
-
- Mental Health Counselor
- Glendale, WI
- NPI 1316360092
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738195200000",
"number": "1366114332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6539 ANTHONY DR STE A",
"city": "VICTOR",
"state": "NY",
"postal_code": "145641441",
"telephone_number": "585-398-8835",
"fax_number": "585-398-7376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6539 ANTHONY DR STE A",
"city": "VICTOR",
"state": "NY",
"postal_code": "145641441",
"telephone_number": "585-398-8835",
"fax_number": "585-398-7376"
}
],
"practiceLocations": [
{
"address_1": "1720 W Florist Ave Ste 125",
"address_purpose": "LOCATION",
"city": "Glendale",
"state": "WI",
"postal_code": "532093862",
"country_code": "US",
"telephone_number": "414-247-0801",
"fax_number": "414-247-0816",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "242 W Main St Apt 408",
"address_purpose": "LOCATION",
"city": "Rochester",
"state": "NY",
"postal_code": "146141147",
"country_code": "US",
"telephone_number": "515-571-0848",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NORDLUND",
"first_name": "NATALIE",
"middle_name": "OLIVIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-29",
"last_updated": "2025-01-30",
"certification_date": "2025-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "4372491",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "WI",
"license": "3001026894",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "5239-57",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Victor, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.