NICOLE LYNN SHAY (NPI# 1255627279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255627279 |
| Entity Type | Individual |
| Full Name | NICOLE LYNN SHAY |
| Credential | PH.D. |
| Practice Address |
721 American Ave Ste 406 Waukesha WI 53188-5071 |
| Mailing Address |
721 American Ave # Suiet406 Waukesha WI 53188-5071 |
| Practice Telephone | 2629287674 |
| Practice Fax Number | 2629285580 |
| Mailing Telephone | 2629287674 |
| Mailing Fax Number | 2629285580 |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2017-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
3519 | WI | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PS01245 | RI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | PROFESSIONAL LICENSE | PS01245 | 01 |
| Street Address |
721 AMERICAN AVE STE 406 |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53188-5071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861625220 | Rebecca L Torres | Clinical Neuropsychologist | 721 American Ave Ste 406, Waukesha, WI 53188-5071 | 2009-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336787126 | Nicole Lee Berg-johnson | Nurse Practitioner | 820 Crestwood Dr., Waukesha, WI 53188 | 2019-12-12 |
| 1013475706 | Rachel Mueller | Occupational Therapist | 29667 Summit Ave, S11, Waukesha, WI 53188 | 2019-03-12 |
| 1861962649 | Emily Elizabeth Seefeld | Occupational Therapy Assistant | 29667 Summit Ave S11, Waukesha, WI 53188 | 2018-12-05 |
| 1003393307 | Ashley Susan Callahan | Dental Hygienist | 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188 | 2018-07-19 |
| 1245741321 | Melissa Weir | Case Manager/Care Coordinator | 514 Riverview Avenue, Waukesha, WI 53188 | 2017-10-17 |
| 1093233629 | Patricia Marie Sombrio | Dental Hygienist | 711 Moreland Blvd 204, Waukesha, WI 53188 | 2017-09-04 |
| 1134660244 | Bdg of Wisconsin, Inc. | Behavioral Analyst | N19w2309 Riverwood Drive, Suite 350 Pmb 314, Waukesha, WI 53188 | 2017-03-09 |
| 1255888731 | Lynne Sarah Alva | Dental Hygienist | 711 Moreland Blvd, Suite 204, Waukesha, WI 53188 | 2016-09-01 |
| 1881069730 | Michelle Koch | Occupational Therapist | 29667 Summit Ave. S11, Waukesha, WI 53188 | 2015-12-03 |
| 1952711012 | Rhonda Schroeder | Dental Hygienist | W286 N991 Shepherds Way, Waukesha, WI 53188 | 2014-04-29 |
| Find all providers in zip 53188 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073683413 | Amy M Schley | Psychologist | 204 Wisconsin Ave, Waukesha, WI 53186-4927 | 2006-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376068379 | Monica L Gremillion | Psychologist | 9000 W Wisconsin Ave # Ms 958, Milwaukee, WI 53226-4874 | 2017-08-10 |
| 1861808412 | Jeffrey Karst | Psychologist | 8701 Watertown Plank Rd., Mfrc 3018, Medical College of Wisconsin Pediatric Hem/onc/bmt, Milwaukee, WI 53226 | 2014-07-03 |
| 1265634505 | Kimberly Arlene Young | Psychologist | 3505 N 124th St, Uppr, Brookfield, WI 53005-2489 | 2007-05-31 |
| 1740229079 | Mary Margaret Rhoades | Psychologist | 5 Odana Ct, Madison, WI 53719-1120 | 2006-06-05 |
| 1861458093 | Anton C Smets | Psychologist | 101 N Farwell St Ste 204, Eau Claire, WI 54703-3767 | 2006-04-25 |
| 1265408173 | Marianne B Burton | Psychologist | 3610 Michelle Witmer Memorial Dr., New Berlin, WI 53151 | 2006-02-28 |
| 1003398868 | Megan Kay Higinbotham | Psychologist | 430 E Division St, Fond Du Lac, WI 54935-4597 | 2018-08-29 |
| 1134645724 | Kelsie-marie Offenwanger | Psychologist | 1000 N Oak Ave, Marshfield, WI 54449-5703 | 2017-08-16 |
| 1699155648 | Center for Language Acquisition and Social Skills Intervention, LLC | Psychologist | 8239 W Hillview Dr, Mequon, WI 53097-3205 | 2015-06-04 |
| 1932501053 | Christopher Waser | Psychologist | 1524 S Lee St, Appleton, WI 54915-3822 | 2014-09-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on NICOLE LYNN SHAY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.