Anne-Marie Caroline Nicolas

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY8211 Issued in FL

Practice address

4404 S Florida Ave
Suite #3
Lakeland, FL 33813-2169

Phone

(863) 709-8110

NPI assigned

Jul 10, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Anne-Marie Caroline Nicolas Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bettye West & Associates, Inc.

  • Mental Health Counselor
  • Lakeland, FL
  • NPI 1063605111
  NPD (past)
• Davken Associates, P.C.

  • Clinical Psychologist
  • Deerfield, IL
  • NPI 1457393159
  NPD (past)

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1437414919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 KINGSMILL CV",
            "address_2": "#210",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465839",
            "telephone_number": "407-314-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4404 S FLORIDA AVE",
            "address_2": "SUITE #3",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132169",
            "telephone_number": "863-709-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLAS",
        "first_name": "ANNE-MARIE",
        "middle_name": "CAROLINE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE-MARIE",
            "last_name": "NICOLAS",
            "middle_name": "CAROLINE",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shon Nguyen, RDN
• Toan Thien Nguyen, M.D.
• Nic 5 Lake Morton Plaza Leasing LLC
• Richard D Nichols, M.D.
• Shurine L Nichols, NURSE PRACTITONER
• Selena Sabine Nicotra, DO
• Emilee Rebecca Niekro, CRNA
• Matthew Grant Nier, DO
• Isabella Nieto, MD
• Nancy Nieves-Cruz, MD

• Clinical Psychologist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.