MEDICARE: INTEGRATIVE NURSE PRACTITIONER IN PSYCHIATRY PLLC

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1639985435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATIVE NURSE PRACTITIONER IN PSYCHIATRY PLLC

Provider Business Mailing Address
First Line	:	81 DARTWOOD DR
Second Line	:
City	:	CHEEKTOWAGA
State	:	NY
Zip	:	14227-3121
Country	:	US
Telephone Number	:	716-578-5788
Fax Number	:

Provider Business Practice Location Address
First Line	:	5775 BROADWAY ST
Second Line	:
City	:	LANCASTER
State	:	NY
Zip	:	14086-2456
Country	:	US
Telephone Number	:	716-544-8848
Fax Number	:	888-612-0831

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. NICHOLE MARIE MCLEOD
Credential	:	PMHNP
Telephone Number	:	716-578-5788

Provider Enumeration Date	:	12/06/2024
Last Update Date	:	10/28/2025

Similar Medicare Providers

1578432589 — SALAH NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Practice Location Address:

5775 BROADWAY ST
LANCASTER, NY
14086-2456

Practice Phone: 716-427-4803
Practice Fax:

1730858721 — NICHOLE MARIE MCLEOD PMHNP
Practice Location Address:

5775 BROADWAY ST
LANCASTER, NY
14086-2456

Practice Phone: 716-544-8848
Practice Fax: 888-612-0831

1952052656 — CINDY MCCONNELL PMHNP
Practice Location Address:

5775 BROADWAY ST
LANCASTER, NY
14086-2456

Practice Phone: 716-544-8848
Practice Fax: 888-612-0831

1871311621 — KENDRA CHOINSKI
Practice Location Address:

5775 BROADWAY ST
LANCASTER, NY
14086-2456

Practice Phone: 716-544-8848
Practice Fax: 888-612-0831

1609412220 — MRS. SHARAI LYNN KINGSTON CDR
Practice Location Address:

2456 LANCASTER RD
RICHMOND, KY
40475-8809

Practice Phone: 512-755-3702
Practice Fax:

1649882978 — MS. SHINECE DOUGLAS
Practice Location Address:

43874 SPRING ST
LANCASTER, CA
93536-2456

Practice Phone: 559-328-9680
Practice Fax:

Directions to “INTEGRATIVE NURSE PRACTITIONER IN PSYCHIATRY PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.