Nicole Carlson, LCSW, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

276452 Issued in AZ

Practice address

2600 E Southern Ave Ste C3
Tempe, AZ 85282-7609

Phone

(626) 515-8875

NPI assigned

Jan 26, 2018

Last updated

Mar 14, 2026By 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 4

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

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.

• Banner Telehealth LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Scottsdale, AZ
  • NPI 1396492005
  Medicare reassignment NPD
• Wanderist Behavioral Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tempe, AZ
  • NPI 1295559441

  Clinical

  NPD Authorized official
• Banner Telehealth LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucson, AZ
  • NPI 1386352714
  NPD
• Phoenix Health and Wellbeing LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tempe, AZ
  • NPI 1619639556

  Clinical

  NPD (past)

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

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773446400000",
    "number": "1427556240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 E SOUTHERN AVE STE C3",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827609",
            "telephone_number": "626-515-8875",
            "fax_number": "480-879-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 E SOUTHERN AVE STE C3",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827609",
            "telephone_number": "626-515-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "NICOLE",
        "credential": "LCSW, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-26",
        "last_updated": "2026-03-14",
        "certification_date": "2026-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "276452",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-19986",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "276452",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP70017008",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caring Hearts Homecare
• Caring Hearts Medical LLC
• Bronwyn Carlblom, NMD
• Rebecca Dawn Carlson Bell, D.C.
• Jessica Carlson, PT, DPT
• Carlton a Richie III DO PLC
• David Bennett Carlyon, D.C.
• Mariah Carmichael
• Katherine Carnes
• Carolyn B Pace MD PC

• Psychiatric/Mental Health Nurse Practitioner in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2026; 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.