Nicole Humphrey, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3250 Issued in OR

Practice address

2600 Center St NE
Salem, OR 97301-2669

Phone

(503) 519-8972

NPI assigned

Aug 4, 2020

Last updated

Mar 4, 2021By 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

Medicare fee-for-service enrollment

Enrolled in OR

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

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Portland DBT Institute IncGroup PAC ID 7911141742, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Portland DBT Institute, Inc.

  dba Portland DBT Institute of Salem

  • Cognitive & Behavioral Psychologist
  • Portland, OR
  • NPI 1073853966
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1689284739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 CENTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 CENTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012669",
            "telephone_number": "503-519-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "NICOLE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Anne Marie Hulett, LPC-ASSOCIATE
• Hailey Hulsey
• Roger William Humble, CADC1
• Charissa E Humlie
• Judi Lynne Humphrey, RN
• Hung D Tran MD LLC
• Laura Teresa Hunker
• Hunsaker Dental
• Travis J Hunsaker, D.D.S.
• Richard Allen Hunt, M.D.

• Clinical Psychologist in Salem, OR
• Providers in Salem, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.