Individual provider Active NPI

Nicole Sommerich, PSYD

  • Mental Health Counselor
  • Braintree, MA
National Provider Identifier
1568129542
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
250 Pond St
Braintree, MA 02184-5351
Phone
(781) 348-2258
Fax
(781) 348-2132
NPI assigned
Nov 24, 2021
Last updated
Jul 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

250 Pond St
Braintree, MA 02184-5351

Mailing address

250 Pond St
Braintree, MA 02184-5351
Phone (781) 348-2258

Other names 1

  • Nicole Marie Coolbrith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240207002518 MA Practitioner - Clinical Psychologist 5193168052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifedimensions Neuropsychological Services IncGroup PAC ID 4587654637, 2 clinicians

Practice addresses (Care Compare)

250 Pond St
Braintree, MA 02184-5351
Phone (781) 348-2258

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifedimensions Neuropsychological Services, Inc CurrentSince Dec 26, 2023 Accepting new patients

Locations

250 Pond St
Braintree, MA 02184
Phone (781) 848-1300

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1568129542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 POND ST",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845351",
            "telephone_number": "781-348-2258",
            "fax_number": "781-348-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 POND ST",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845351",
            "telephone_number": "781-348-2258",
            "fax_number": "781-348-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMMERICH",
        "first_name": "NICOLE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-24",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "COOLBRITH",
            "middle_name": "MARIE",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Braintree, MA

Sources for this page

Verify at the official NPI Registry.