Nicole G Martell, PSY.D., MBA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4906 Issued in NJ

Practice address

147 Union Ave
Suite 202
Manasquan, NJ 08736-3648

Phone

(732) 962-3594

NPI assigned

Aug 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2018 through Oct 1, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration

State licenses

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1962750141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 UNION AVE",
            "address_2": "SUITE 202",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087363648",
            "telephone_number": "732-962-3594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 UNION AVE",
            "address_2": "SUITE 202",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087363648",
            "telephone_number": "732-962-3594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTELL",
        "first_name": "NICOLE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PSY.D., MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "4906",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016061",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin E Manzo, D.C.
• Kelli Katherine Marchitello, LPC, BCBA
• Mark M. Seckler, M.D., P.a.
• Mark White, PH.D., P.a.
• Alanna Marrero, LPC
• Bianca Martinez, MD
• Michael Bruno Maschi, LCSW
• Bethany Catherine Mattson, LAC
• Paul Stephen Mazur, O.D.
• Kasey Rose McAteer

• Clinical Psychologist in Manasquan, NJ
• Providers in Manasquan, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.