Nicole Joy Slavik, PSY.D. , LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP 5609 Issued in MN

Practice address

6425 Nicollet Ave
Richfield, MN 55423-1675

Phone

(612) 798-8170

NPI assigned

Apr 25, 2013

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 3

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

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.

• Center for Collaborative Health PLLC

  • Counseling Psychologist
  • Edina, MN
  • NPI 1417328808
  NPD Authorized official

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

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366848000000",
    "number": "1609210251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 NICOLLET AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231675",
            "telephone_number": "612-798-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 NICOLLET AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231675",
            "telephone_number": "612-798-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAVIK",
        "first_name": "NICOLE",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "PSY.D. , LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-25",
        "last_updated": "2013-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP 5609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87055600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1750552196",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "C01290",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raluca Otilia Sima, O.D.
• Harpreet Singh, MD
• Neerja Singh, PHD, LICSW
• Sisters Home Health Care LLC
• Merryn Skarphol-Pellizzer
• Gabrielle Lenore Smerillo, DNP
• Brianca Smith, LPCC
• Hannah Smith, MS, RD, LD
• Helene Margaret Smith
• Jennifer Lynn Smith, PAC

• Psychologist in Richfield, MN
• Providers in Richfield, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.