Kathy Rosalie Nicholls, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY8492 Issued in FL

Practice address

10094 Oak Meadow LN
Lake Worth, FL 33449-5467

Phone

(561) 370-4439

NPI assigned

Sep 10, 2012

Sex

Female

Sole proprietor

No

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

Enrolled in FL

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

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Psychological and Forensic Services

  • Clinical Psychologist
  • Greenacres, FL
  • NPI 1659763191
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352851200000",
    "number": "1952651606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10094 OAK MEADOW LN",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334495467",
            "telephone_number": "561-370-4439",
            "fax_number": "561-721-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10094 OAK MEADOW LN",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334495467",
            "telephone_number": "561-370-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLLS",
        "first_name": "KATHY",
        "middle_name": "ROSALIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY8492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Newby
• Kayla S Newton
• Next Step Recovery
• Diem-CHI Nguyen
• Trami Nguyen
• Frances Nichols, CNA
• James Joseph Nicholson, L.M.H.C.
• Jacqueline Naomi Nicolas, RPH
• Nicole Vanessa Nieto
• Jessica J Nilles, PT

• Psychologist in Lake Worth, FL
• Providers in Lake Worth, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.