Individual provider Active NPI

Nicole Speight, NCC

  • Addiction (Substance Use Disorder) Counselor
  • Rochester, NY
National Provider Identifier
1922532886
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
338815 Issued in NY
Practice address
3300 Dewey Ave
Rochester, NY 14616-3741
Phone
(585) 865-1555
Fax
(585) 663-1709
NPI assigned
Apr 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 338815 NY Primary

Addresses

Primary practice location

3300 Dewey Ave
Rochester, NY 14616-3741

Mailing address

3300 Dewey Ave
Rochester, NY 14616-3741
Phone (585) 865-1555

Other names 1

  • Nicole Kramell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240829003938 NY Practitioner - Mental Health Counselor 0840739181 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
338815NYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Villa of Hope CurrentSince Jun 22, 2024 Accepting new patients

Locations

3300 Dewey Ave
Rochester, NY 14616
Phone (585) 865-1550

247 N Goodman St
Rochester, NY 14607
Phone (585) 627-5892

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1922532886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 DEWEY AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146163741",
            "telephone_number": "585-865-1555",
            "fax_number": "585-663-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 DEWEY AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146163741",
            "telephone_number": "585-865-1555",
            "fax_number": "585-663-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEIGHT",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "338815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "KRAMELL",
            "credential": "NCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.