Nicole Roberta Claudin, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704285765 Issued in MI

Practice address

10 Peterboro St
Detroit, MI 48201-2722

Phone

(313) 649-4954

Fax

(313) 309-1090

NPI assigned

Jun 24, 2015

Last updated

Aug 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Behavioral Care Solutions for Adults and Seniors, Inc.

  • Psychiatry Physician
  • Novi, MI
  • NPI 1154727147

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Detroit Central City Community Mental Health Inc.

  dba Central City Health

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1285043406
  Medicare reassignment
• Vista Maria

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Dearborn Heights, MI
  • NPI 1477639458
  NPD
• Vista Maria Good Shepherd

  • Community/Behavioral Health Agency
  • Dearborn Heights, MI
  • NPI 1497928816
  NPD
• Downriver Mental Health Clinic PC

  dba Lifestance Health, Inc

  • Psychologist
  • Taylor, MI
  • NPI 1295866135
  NPD (past)

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1407238694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PETERBORO ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012722",
            "telephone_number": "313-831-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PETERBORO ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012722",
            "telephone_number": "313-649-4954",
            "fax_number": "313-309-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAUDIN",
        "first_name": "NICOLE",
        "middle_name": "ROBERTA",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704285765",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704285765",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicki Marie Clark, RN
• Yameka Clark
• Anthony W Clarke, M.D.
• Clarkston Physical Therapy and Rehabilitation Center
• Carol Classen
• Claudio Holdings LLC (Detroit Eyecare)
• Claudio Holdings LLC (Detroit Eyecare)
• David Jacob Clausen, MD
• Christopher Gerald Clavon
• Krystal Clavon, BSW

• Psychiatric/Mental Health Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.