Nicole Lacoste Cantley, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3520 Issued in NC

Practice address

2101 Sardis Rd N
Suite 220
Charlotte, NC 28227

Phone

(704) 841-1163

Fax

(704) 841-1164

NPI assigned

Mar 25, 2008

Last updated

May 23, 2018By 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 1

Addresses

Other names 1

• Nicole Marie Lacoste Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2022 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charlotte Psychological Assessment II PA

  • Clinical Psychologist
  • Charlotte, NC
  • NPI 1306157888
  NPD (past) Authorized official
• Charlotte Psychological Assessment, PA

  • Clinical Psychologist
  • Charlotte, NC
  • NPI 1801062674
  Authorized official Same address or phone

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1558533968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 SARDIS RD N",
            "address_2": "SUITE 220",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28227",
            "telephone_number": "704-841-1163",
            "fax_number": "704-841-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 SARDIS RD N",
            "address_2": "SUITE 220",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28227",
            "telephone_number": "704-841-1163",
            "fax_number": "704-841-1164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1811 Sardis Rd N",
            "address_2": "Suite 207",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282701426",
            "country_code": "US",
            "telephone_number": "704-841-1163",
            "fax_number": "704-841-1164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANTLEY",
        "first_name": "NICOLE",
        "middle_name": "LACOSTE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-25",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "LACOSTE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Canopus Health Inc (Star Bright Pharmacy)
• Canopy Counseling and Consulting
• Emily Cantera
• Sheryl Runay Cantey, PSY.D.
• Felicia Cantey,, M.A., CCC-SLP
• Kara L Cantoni, OTR/L
• Sherry Cavanagh Cantrell, LCSWA
• Julia Cantwell
• Nina Cantwell
• Arrica Canty

• Clinical Psychologist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.