Individual provider Active NPI

Nicole Stevens

  • Cognitive & Behavioral Psychologist
  • Buffalo, NY
National Provider Identifier
1790244762
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
Practice address
70 Jewett Pkwy
Buffalo, NY 14214-2322
Phone
(678) 638-9483
NPI assigned
Mar 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X Primary

Addresses

Primary practice location

70 Jewett Pkwy
Buffalo, NY 14214-2322

Mailing address

70 Jewett Pkwy
Buffalo, NY 14214-2322
Phone (678) 638-9483

Medicare participation

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

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1790244762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 JEWETT PKWY",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142322",
            "telephone_number": "678-638-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 JEWETT PKWY",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142322",
            "telephone_number": "678-638-9483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.