Individual provider Active NPI

Nicole Teresa Ciavarella

  • Mental Health Counselor
  • White Bear Lake, MN
National Provider Identifier
1730860032
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4756 Banning Ave
White Bear Lake, MN 55110-3205
Phone
(845) 826-1190
NPI assigned
Jul 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

4756 Banning Ave
White Bear Lake, MN 55110-3205

Mailing address

523 Jackson St Unit 311
Saint Paul, MN 55101-2469
Phone (845) 826-1190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1730860032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 JACKSON ST UNIT 311",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012469",
            "telephone_number": "845-826-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4756 BANNING AVE",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103205",
            "telephone_number": "845-826-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIAVARELLA",
        "first_name": "NICOLE",
        "middle_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

Verify at the official NPI Registry.