Nichol Shabazz, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ15611300 Issued in NJ

Practice address

470 Chamberlain Ave Ste 11
Paterson, NJ 07522-1000

Phone

(973) 930-0052

NPI assigned

Apr 30, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Life Transformation Wellness Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Paterson, NJ
  • NPI 1437907250

  Health & Wellness Coach

  NPD Authorized official

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1750138699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1072",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074108072",
            "telephone_number": "973-930-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 CHAMBERLAIN AVE STE 11",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075221000",
            "telephone_number": "973-930-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABAZZ",
        "first_name": "NICHOL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-30",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15611300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgina Maria Sesana, MD
• Monique G. Severe, M.D.
• Rehan Hassanin Seyam
• Donald Sgroi, M.D.
• Glorious Ali Shabazz
• Fady Fawzy Shafeek, MD
• Abhi Shah, PHARM.D
• Bindesh Kiran Shah, RPH
• Dinesh H Shah, M.D.
• Mihir Shah

• All providers in Paterson, NJ
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.