Active NPI
Lisa Nichols, PH.D.
- Psychiatric Hospital
- Brooklyn, NY
National Provider Identifier
1699822734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- License
- 016302-1
- Practice address
- 1545 Atlantic Avenue
Brooklyn, NY 11213 - Phone
- (718) 613-6618
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | 016302-1 | NY | Primary |
Addresses
Primary practice location
1545 Atlantic Avenue
Brooklyn, NY 11213
Mailing address
414 E 88TH St Apt 1a
New York, NY 10128-6684
Phone (917) 257-8481
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016302-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699822734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 E 88TH ST APT 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101286684",
"telephone_number": "917-257-8481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1545 ATLANTIC AVENUE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11213",
"telephone_number": "718-613-6618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "LISA",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": "NY",
"license": "016302-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.