Nicole Clay

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY61086980 Issued in WA

Practice address

2370 130TH Ave NE Ste 104
Bellevue, WA 98005-1770

Phone

(425) 628-2820

NPI assigned

May 2, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 7, 2024 through Jul 7, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Dr. Kathleen Worsley

  • Counseling Psychologist
  • Redmond, WA
  • NPI 1619484821
  NPD (past)
• Pacific Behavioral Healthcare

  • Mental Health Counselor
  • Bellevue, WA
  • NPI 1932529120
  NPD (past)

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1922534569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 161ST AVE NE STE 202",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523858",
            "telephone_number": "425-996-8592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2370 130TH AVE NE STE 104",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051770",
            "telephone_number": "425-628-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61086980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Clarke, MA, LMFTA
• Margaret Clarkson
• Ivone Claros-Carvalho, L.M.P.
• William Clave, D.M.D
• Barbara Clavel
• Charles J Clayton, OD
• Clear Mind Clinic PLLC
• Patricia Denise Cleavinger, DDS
• Samantha Erin Clem, PA-C
• Amrita Clements, MFTA

• Clinical Psychologist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.