Nicole Marie Kline, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P.07732 Issued in OH

Practice address

3591 Reserve Commons Dr Ste 301
Medina, OH 44256-5334

Phone

(330) 764-7916

Fax

(330) 723-6399

NPI assigned

Jun 14, 2018

Sex

Female

Sole proprietor

Yes

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 OH, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Stonebridge Behavioral Health, P.a.

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1861528390
  Medicare reassignment NPD
• Psychology Consultants Inc

  • Clinical Social Worker
  • Medina, OH
  • NPI 1205882941
  Medicare reassignment

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1740773621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3591 RESERVE COMMONS DR STE 301",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565334",
            "telephone_number": "330-764-7916",
            "fax_number": "330-723-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3591 RESERVE COMMONS DR STE 301",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565334",
            "telephone_number": "330-764-7916",
            "fax_number": "330-723-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "P.07732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Kitchen, MFT-T
• Richard Kiwala, LPN
• Lisa Anne Klatka, D.O.
• Nicola Klein, PRS
• Jodi J Kleinfeld
• Erin T Klubnik, CDCA SWA
• Samantha Koeberle, BSW, LSW
• Stacia Michele Kogut, CNP
• Catherine R Kolleth, LPCC-S, LMFT
• Stephanie Kolodziej, OTR/L

• Clinical Psychologist in Medina, OH
• Providers in Medina, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.