Nicole Smith, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5942 Issued in CT

Practice address

404 Thames St FL 3
Groton, CT 06340-3959

Phone

(860) 245-9240

NPI assigned

Feb 7, 2020

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

• Nicole Blanchet Former name

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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.

• Holistic Counseling and Wellness LLC

  • Professional Counselor
  • Groton, CT
  • NPI 1740036300
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1639701667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 S FRONTAGE RD # 1042",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063202641",
            "telephone_number": "860-245-9240",
            "fax_number": "860-650-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 THAMES ST FL 3",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403959",
            "telephone_number": "860-245-9240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37 S Broad St",
            "address_purpose": "LOCATION",
            "city": "Pawcatuck",
            "state": "CT",
            "postal_code": "063797909",
            "country_code": "US",
            "telephone_number": "860-437-4550",
            "fax_number": "860-661-4262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICOLE",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "5942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "BLANCHET",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brigid Agnes Smith, FNP
• Christopher Lee Roy Smith, SUBMARINE IDC
• Hannah Marie Smith, LMSW
• Jessica Smith
• Kathleen Confrey Smith, LCSW
• Rebecca Z Smith
• Serita M Smith, APRN
• William Anthony Smithson, PSYD
• Sol Integrative Wellness, LLC
• Kristine Elizabeth Sonstrom Malowski, AU.D., PH.D.

• Professional Counselor in Groton, CT
• Providers in Groton, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.