Individual provider Active NPI

Nickisha Newell, BS

  • Mental Health Counselor
  • East Hartford, CT
National Provider Identifier
1962903567
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
287 Main St
East Hartford, CT 06118-1885
Phone
(860) 569-5900
NPI assigned
Feb 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Mental Health Counselor 101YM0800X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X

Addresses

Primary practice location

287 Main St
East Hartford, CT 06118-1885

Mailing address

287 Main St
East Hartford, CT 06118-1885
Phone (860) 569-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240722001088 CT Practitioner - Clinical Social Worker 9234675794 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intercommunity IncGroup PAC ID 9032001649, 36 clinicians

Practice addresses (Care Compare)

281 Main St
East Hartford, CT 06118-1823
Phone (860) 291-1335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
13901CTMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Sep 25, 2024 Accepting new patients
Intercommunity, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Boldbravefearless Counseling and Consulting LLC Mental Health Current Accepting new patients
Intercommunity, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Community Mental Health Affiliates Inc Past Accepting new patients

Locations

287 Main St
East Hartford, CT 06118
Phone (860) 716-2518

281 Main St
East Hartford, CT 06118
Phone (860) 291-1335

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

16 Coventry St
Hartford, CT 06112
Phone (860) 714-3701

800 Connecticut Blvd
Fl 4
Hartford, CT 06108
Phone (860) 622-5451

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 5

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": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1962903567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 MAIN ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181885",
            "telephone_number": "860-569-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 MAIN ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181885",
            "telephone_number": "860-569-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWELL",
        "first_name": "NICKISHA",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

Verify at the official NPI Registry.