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NPI Code Detail

MEDICARE: DR. NICOLE M BARCELOS PSY.D.

MEDICARE:  DR. NICOLE M BARCELOS  PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103G00000XClinical Neuropsychologist3566CT
2103TC0700XClinical Psychologist3566CT
3103G00000XClinical Neuropsychologist021324NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PRC200326293OTHERNYCAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN, INC.
2000427298001OTHERNYBLUESHIELD OF NORTHEASTERN NY
3V38N41OTHERNYEMPIRE BLUECROSS

General Provider Information

NPI Number : 1467820944
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICOLE M BARCELOS PSY.D.
Provider Business Mailing Address
First Line : 100 DEERFIELD RD
Second Line :
City : WINDSOR
State : CT
Zip : 06095-4252
Country : US
Telephone Number : 860-270-0600
Fax Number : 860-748-4432
Provider Business Practice Location Address
First Line : 100 DEERFIELD RD
Second Line :
City : WINDSOR
State : CT
Zip : 06095-4252
Country : US
Telephone Number : 860-270-0600
Fax Number : 860-748-4432
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2015
Last Update Date : 01/07/2026

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Directions to “ DR. NICOLE M BARCELOS PSY.D.” Practice Location

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