Nicole Surething, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0810004081 Issued in VA

Practice address

1158 Professional Dr Ste N
Williamsburg, VA 23185-6618

Phone

(540) 693-0398

Fax

(844) 386-6313

NPI assigned

Oct 14, 2014

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Wellness Therapy Services, LLC

  • Community/Behavioral Health Agency
  • Williamsburg, VA
  • NPI 1306296819
  NPD Authorized official
• Nacmed

  • Clinical Neuropsychologist
  • Fredericksburg, VA
  • NPI 1306360425
  NPD (past)

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1902200389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3997 CEDARWOOD LN",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231888007",
            "telephone_number": "540-693-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1158 PROFESSIONAL DR STE N",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231856618",
            "telephone_number": "540-693-0398",
            "fax_number": "844-386-6313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURETHING",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810004081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert E Sullivan
• Carter Wheeler Summerville
• Summit Medical Consultants, LLC
• Kory Supplee
• Supreme Helpers Healthcare Corporation
• Surgery Center Anesthesia Providers PC
• Surgical Suites of Coastal Virginia, LLC
• Reshonn Nicole Sutphin
• Richard Michael Swaine, MA LPC
• Jessica L Swan, MCJ, LSATP, MAC, CAS

• Psychologist in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.