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DR. NICOLE PETZOLT PSY.D. NPI 1063836500


NPI Information

NPI: 1063836500
Provider Name: DR. NICOLE PETZOLT, PSY.D.
Classification: Psychologist - 103TC0700X
Entity Type: Individual

Specialization: Clinical

Organization: CHE BEHAVIORAL HEALTH SERVICES OF FLORIDA, P.A.

PECOS Registration: Yes

Address:
3512 QUENTIN RD STE 110
BROOKLYN, NY
ZIP 11234
Phone: (718) 854-8370
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DR. Nicole Petzolt, PSY.D. is a clinical psychologist in Brooklyn, NY with 13 years of experience. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. DR. Nicole Petzolt, PSY.D. NPI is 1063836500. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3512 QUENTIN RD STE 110
BROOKLYN, NY
ZIP 11234-245
Phone: (718) 854-8370

The NPI 1063836500 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 2/4/2014 and was last updated on 5/13/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103T00000XPsychologist020428-1NEW YORKNo
2103TA0700XPsychologistAdult Development & Aging020428-1NEW YORKNo
3103TC0700XPsychologistClinical020428-1NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.