Individual provider Active NPI

Nichole M. Robinson, PSYD

  • Professional Counselor
  • Dresher, PA
National Provider Identifier
1750800173
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC009871 Issued in PA
Practice address
3103 Alpin Dr
Dresher, PA 19025-1601
Phone
(215) 804-8582
NPI assigned
Sep 18, 2017
Last updated
Feb 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC009871 PA Primary

Addresses

Primary practice location

3103 Alpin Dr
Dresher, PA 19025-1601

Mailing address

3103 Alpin Dr
Dresher, PA 19025-1601
Phone (215) 804-8582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240325000876 PA Practitioner - Mental Health Counselor 3971940107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1300 Virginia Dr
Suite 110a
Fort Washington, PA 19034-3221
Phone (215) 804-8582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC009871PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Phase Counseling, LLC CurrentSince Jan 2, 2024 Accepting new patients
Liv Associates, Inc. PastSince Jul 1, 2022 Accepting new patients
Liv Well Associates PastSince Jul 1, 2022 Accepting new patients

Locations

1300 Virginia Dr
Ste 110A
Fort Washington, PA 19034
Phone (215) 804-8582

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1750800173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 ALPIN DR",
            "city": "DRESHER",
            "state": "PA",
            "postal_code": "190251601",
            "telephone_number": "215-804-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 ALPIN DR",
            "city": "DRESHER",
            "state": "PA",
            "postal_code": "190251601",
            "telephone_number": "215-804-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "NICHOLE",
        "middle_name": "M.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC009871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dresher, PA

Sources for this page

Verify at the official NPI Registry.