Nicole Marie Buffolino, LMHC
Individual provider Active NPI Mental Health Counselor · Wantagh, NY
NPI 1912435504 · NPPES record last updated Jun 20, 2019
Key facts
- NPI
- 1912435504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 007902 (NY)
- Practice address
- 3330 Park Ave
Wantagh, NY 11793-3719 - Phone
- (516) 730-3447
- NPI assigned
- May 26, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007902 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Laura Haas LCSW & Associates | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 007902 | NY | Yes |
Addresses
Primary practice location
3330 Park Ave
Wantagh, NY 11793-3719
Mailing address
73 Crest Rd W
Merrick, NY 11566-1412
Other practice location 1
201 N Delaware Ave
Massapequa, NY 11758-1869
Phone (516) 753-3691
Other providers in Wantagh, NY
- Alexandra Brown
- Susan Marie Browne
- Ashley Rose Browning
- Christie Marie Brulhardt
- Marianne Elizabeth Brulhardt
- Jamie Bunsis
- Amanda Denise Buonora
- David M Burgess
- Christine A Burrows
- Patrick Butler
All providers in Wantagh, NY · Mental Health Counselor in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.