Active NPI
Nicole Michelle Iannelli, LCMHC
- Mental Health Counselor
- Cranston, RI
National Provider Identifier
1699865154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MHC00175
- Practice address
- 54 Sycamore Dr
Cranston, RI 02921-1015 - Phone
- (401) 497-5108
- NPI assigned
- Oct 13, 2006
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MHC00175 | RI | Primary |
Addresses
Primary practice location
54 Sycamore Dr
Cranston, RI 02921-1015
Mailing address
54 Sycamore Dr
Cranston, RI 02921-1015
Phone (401) 497-5108
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 409945 | Other | RI | BLUE CHIP |
| 231701 | Other | RI | BLUE CROSS BLUE SHIELD |
| 6247759 | Other | RI | UNITED HEALTH CARE |
| NI43573 | Medicaid | RI | |
| 470077 | Other | RI | TUFTS |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MHC00175 | RI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471478400000",
"number": "1699865154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 SYCAMORE DR",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029211015",
"telephone_number": "401-497-5108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 SYCAMORE DR",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029211015",
"telephone_number": "401-497-5108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IANNELLI",
"first_name": "NICOLE",
"middle_name": "MICHELLE",
"credential": "LCMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2016-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "RI",
"license": "MHC00175",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "409945",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "231701",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "6247759",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NI43573",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "470077",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cranston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.