Nicole D Canterella, PMHNP, BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2157992 Issued in FL

Practice address

130 S Indian River Dr Ste 202
Fort Pierce, FL 34950-4353

Phone

(772) 773-0229

Fax

(772) 272-8600

NPI assigned

Aug 29, 2008

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Suncoast Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Fort Pierce, FL
  • NPI 1225046550
  NPD (past)

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1508014762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S INDIAN RIVER DR STE 202",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504353",
            "telephone_number": "772-773-0229",
            "fax_number": "772-272-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S INDIAN RIVER DR STE 202",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504353",
            "telephone_number": "772-773-0229",
            "fax_number": "772-272-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTERELLA",
        "first_name": "NICOLE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "PMHNP, BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-29",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "2157992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306269400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Marie Campbell, APRN
• Richard Naugle Campbell, MS, LMHC
• Robert Dwight Campbell, MSW
• Naty Canales
• Kelly Cannon, APRN, FNP-BC
• Jalyssa Cardell
• Irma Cardenosa Garcia, RBT
• Vanessa Cardis
• Care One Support LLC
• Carehere LLC

• Psychiatric/Mental Health Nurse Practitioner in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.