Psyche1001 Learn Grow Change LLC

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

APRN00561 Issued in RI

Legal business name

PSYCHE1001 LEARN GROW CHANGE LLC

Practice address

638 Adamsville Rd
Suite 1001
Westport, MA 02790-5031

Phone

(508) 636-4769

Fax

(508) 636-6463

NPI assigned

Nov 21, 2016

Last updated

Nov 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Marci A McNicol, APRNCNS BCNPI 1184980211

Title

Owner

Phone

(508) 636-4769

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marci A. McNicol, APRNCNS BC

  • Psychiatric/Mental Health Nurse Practitioner
  • New London, CT
  • NPI 1184980211
  NPD (past) Authorized official

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1457894628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 ADAMSVILLE RD",
            "city": "WESTPORT",
            "state": "MA",
            "postal_code": "027905031",
            "telephone_number": "508-636-4769",
            "fax_number": "508-636-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 ADAMSVILLE RD",
            "address_2": "SUITE 1001",
            "city": "WESTPORT",
            "state": "MA",
            "postal_code": "027905031",
            "telephone_number": "508-636-4769",
            "fax_number": "508-636-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHE1001 LEARN GROW CHANGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "MCNICOL",
        "authorized_official_first_name": "MARCI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-636-4769",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRNCNS BC"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "RI",
            "license": "APRN00561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kady Plante-Szady, L.A.T.,C.
• Plaza Pharmacy of Westport, Inc.
• Elizabeth C. Pollin
• Stephen Poulos, B.S
• Protecting All Smiles, LLC
• Rachael Ann Rasmussen
• Rachel E Riker, RDH
• Anna Mae Riley, LPN
• Deborah Rivera-Campion
• Faith Roberts

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Westport, MA
• Providers in Westport, MA by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.