Sherissa-Nicole Martinez Sebastian, DNP, PMHNP-BC, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0998119 Issued in CO

Practice address

12041 Tejon St
Westminster, CO 80234-2314

Phone

(303) 993-7356

NPI assigned

Dec 15, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Sherissa-Nicole Sebastian Manganello Former name

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Amavi Integrative Mental Wellness LLCGroup PAC ID 4082043401, 27 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Amavi Integrative Mental Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Niwot, CO
  • NPI 1841823994
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1487313698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 E CHEYENNE MOUNTAIN BLVD STE F",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064002",
            "telephone_number": "720-808-1082",
            "fax_number": "719-247-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12041 TEJON ST",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342314",
            "telephone_number": "303-993-7356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3475 Briargate Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809204188",
            "country_code": "US",
            "telephone_number": "866-644-6131",
            "fax_number": "719-434-9615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1955 Abbington St",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809104496",
            "country_code": "US",
            "telephone_number": "720-808-1082",
            "fax_number": "719-247-1788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEBASTIAN",
        "first_name": "SHERISSA-NICOLE",
        "middle_name": "MARTINEZ",
        "credential": "DNP, PMHNP-BC, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95106933",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CO",
            "license": "1644417",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0998119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERISSA-NICOLE",
            "last_name": "MANGANELLO",
            "middle_name": "SEBASTIAN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jaclyn Suzanne Sealy, APRN PMHNP
• Dakota Ann Sears, DPT
• Seasons Hospice & Palliative Care of Colorado LLC
• Seasons Medical Group of Colorado, PC
• Brenna Seawalt
• Sedona Dental Associates
• Brady Sefcik
• Julie Marie Sefcik, D.O.
• Cameron Segura Thomas Segura, RD
• Jessica Seifert, LPC

• Psychiatric/Mental Health Nurse Practitioner in Westminster, CO
• Providers in Westminster, CO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.