Nicole Daniella Chaikin, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS015647 Issued in PA

Practice address

1171 Lancaster Ave Ste 100
Berwyn, PA 19312-2602

Phone

(484) 674-6324

Fax

(484) 674-6324

NPI assigned

Jun 19, 2007

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

Opted out of Medicare

Yes, effective Jul 18, 2024 through Jul 18, 2028

Medicare enrollment (NPD)

Not enrolled

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.

• Opal DBT, LLC

  • Clinical Psychologist
  • Berwyn, PA
  • NPI 1124859335

  Clinical

  NPD Authorized official
• Synergy Psychological Associates, LLC

  • Clinical Psychologist
  • Berwyn, PA
  • NPI 1700617941

  Clinical

  NPD Authorized official
• Intercommunity Action, Inc

  • Community/Behavioral Health Agency
  • Phila, PA
  • NPI 1730224445
  NPD (past)

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1962607010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 SANDY LN",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193553027",
            "telephone_number": "610-651-0557",
            "fax_number": "610-651-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 LANCASTER AVE STE 100",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193122602",
            "telephone_number": "484-674-6324",
            "fax_number": "484-674-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAIKIN",
        "first_name": "NICOLE",
        "middle_name": "DANIELLA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS015647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Cappelli, MSOT
• Brittany McGowan Carr, LCSW
• Elizabeth Kroculick Carter, D.C.
• Catherine Clare Casey, M.S. CCC-SLP
• Emma Antonia Chabolla, LSW
• Sarah Chaya, ATC
• Et-Tsu Chen, MD
• Chester Home Care Services LLC
• Chesterbrook Dental Associates, LTD.
• Eric Ciabattoni

• All providers in Berwyn, PA
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.