Nicole Pan, Licensed Mental Health Counselor, PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

005554 Issued in NY

Legal business name

NICOLE PAN, LICENSED MENTAL HEALTH COUNSELOR, PLLC

Practice address

21 Greene Ave
Suite 205
Amityville, NY 11701-2943

Phone

(631) 637-0579

NPI assigned

Nov 4, 2014

Organization subpart

No

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

Authorized official

Name

Nicole PanNPI 1790077519

Title

Licensed Mental Health Counselor

Phone

(631) 637-0579

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Pan, LMHC

  • Mental Health Counselor
  • Amityville, NY
  • NPI 1790077519
  NPD (past) Authorized official

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432512000000",
    "number": "1861897803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117350855",
            "telephone_number": "631-637-0579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GREENE AVE",
            "address_2": "SUITE 205",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012943",
            "telephone_number": "631-637-0579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE PAN, LICENSED MENTAL HEALTH COUNSELOR, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-04",
        "last_updated": "2015-05-25",
        "status": "A",
        "authorized_official_last_name": "PAN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "LICENSED MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "631-637-0579"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Klarenja Nesiva
• William Newton, MD
• David NG, LAC
• Andrew Nguyen, M.D.
• Linda Nicholson, LCSW
• North Amityville Fire Company Inc
• Kathleen A Novick, MA PT
• Ashley Nugent
• Jeffrey K Nussbaum, M.D.
• Ny Care Supplies Corp

• Mental Health Counselor in Amityville, NY
• Providers in Amityville, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2015; 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.