Active NPI
Nicole Caraballo
- Psychologist
- Detroit, MI
National Provider Identifier
1871803247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 3901 Beuabien Blvd
Detroit, MI 48201 - Phone
- (313) 831-3220
- NPI assigned
- Oct 19, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
3901 Beuabien Blvd
Detroit, MI 48201
Mailing address
3901 Beaubien Blvd
2ND Floor, Carls BLDG, Surgery Suite
Detroit, MI 48201
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1871803247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 BEAUBIEN BLVD",
"address_2": "2ND FLOOR, CARLS BLDG, SURGERY SUITE",
"city": "DETROIT",
"state": "MI",
"postal_code": "48201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 BEUABIEN BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "48201",
"telephone_number": "313-831-3220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARABALLO",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-19",
"last_updated": "2023-11-03",
"certification_date": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.