Nichole Marie Phelps Latendresse, M.A

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

328 Main St
Southbridge, MA 01550-3794

Phone

(508) 765-9101

NPI assigned

Apr 9, 2010

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1700102217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 MAIN ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015503794",
            "telephone_number": "401-338-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 MAIN ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015503794",
            "telephone_number": "508-765-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS LATENDRESSE",
        "first_name": "NICHOLE",
        "middle_name": "MARIE",
        "credential": "M.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-09",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "6400144",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanise Margot Perez, CNP
• Calvin H Peterson, PAC
• Kally Ann Petka, FNP
• Petra Health Care LLC
• William Francis Petrone, M.D.
• Jillian E Phillips, LICSW
• Renee Plaisance, DEV. SPECIALIST
• PLKJ Inc.
• Joanna Poluha-O'Neil, M.D.
• Margaret Rose Poole, ARNP, FNP-BC

• Case Manager/Care Coordinator in Southbridge, MA
• Providers in Southbridge, MA by specialty
• Case Manager/Care Coordinator in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.

Verify at the official NPI Registry.