DR. NICOLE PHILLIPS CONNOLLY PH.D.
NPI 1245436369
Psychologist in Santa Clarita, CA

NPI Status: Active since June 25, 2007

Contact Information

25050 PEACHLAND AVE
SUITE 250
SANTA CLARITA, CA
ZIP 91321
Phone: (661) 430-9300

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  • Individual
  • Female
  • Psychologist
  • PECOS Enrolled
  • Opted-Out Medicare

About NICOLE CONNOLLY

This page provides the complete NPI Profile along with additional information for Nicole Connolly, a provider established in Santa Clarita, California with a medical specialization in Psychologist. The healthcare provider is registered in the NPI registry with number 1245436369 assigned on June 2007. The practitioner's primary taxonomy code is 103T00000X with license number PSY23260 (CA). The provider is registered as an individual and her NPI record was last updated 11 years ago.

NPI
1245436369
Provider Name
DR. NICOLE PHILLIPS CONNOLLY PH.D.
Gender
Female
Entity Type
Individual
Location Address
25050 PEACHLAND AVE SUITE 250 SANTA CLARITA, CA 91321
Location Phone
(661) 430-9300
Mailing Address
25050 PEACHLAND AVE SUITE 250 SANTA CLARITA, CA 91321
Mailing Phone
(661) 430-9300
Is Sole Proprietor?
Yes
Enumeration Date
06-25-2007
Last Update Date
06-28-2015
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A psychologist like Nicole Connolly studies cognitive, emotional, social processes and behavior by observing, interpreting, and recording how people relate to one another and to their environments. Psychologists gather information and evaluate behavior through controlled laboratory experiments, psychoanalysis, psychotherapy or through personality, performance, aptitude, or intelligence tests, and use this information when testing theories in their research or when treating patients.

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Nicole Connolly opted out of Medicare effective on 07-03-2023 until 07-03-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychologist

Taxonomy Code
103T00000X
Type
Behavioral Health & Social Service Providers
License No.
PSY23260
License State
CA
Taxonomy Description
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Medicare Participation & PECOS Enrollment Status

Nicole Connolly is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Opted-Out of Medicare? Yes

  • Opt-Out Effective Date: 07-03-2023

  • Opt-Out End Date: 07-03-2027

  • Eligible to Order and Refer? No

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: No

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1245436369, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
4
Doubled → 8
Pos 4
5
Unchanged
Pos 5
4
Doubled → 8
Pos 6
3
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
3
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 4 → 8 6 → 12 → 3 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 8 + 5 + 8 + 3 + 1 + 2 + 3 + 1 + 2 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1245436369.

Other Providers at the Same Location


The following 13 providers are registered at the same or a nearby location.

Chiropractor
25050 PEACHLAND AVE, SUITE 155
NEWHALL, CA 91321
Chiropractor
25050 PEACHLAND AVE, SUITE 155
NEWHALL, CA 91321
Psychiatry & Neurology (Psychiatry)
25050 PEACHLAND AVE, SUITE 203
NEWHALL, CA 91321
Social Worker (Clinical)
25050 PEACHLAND AVE, SUITE 203
NEWHALL, CA 91321
Social Worker (Clinical)
25050 PEACHLAND AVE, #203
NEWHALL, CA 91321
Counselor (Addiction (Substance Use Disorder))
25050 PEACHLAND AVE
NEWHALL, CA 91321
Registered Nurse
25050 PEACHLAND AVE, 203
NEWHALL, CA 91321
Clinical Medical Laboratory
25050 PEACHLAND AVE, SUITE 125
SANTA CLARITA, CA 91321
Chiropractor
25050 PEACHLAND AVE, #105
NEWHALL, CA 91321
Clinic/Center (Sleep Disorder Diagnostic)
25050 PEACHLAND AVE, 125
SANTA CLARITA, CA 91321
Psychologist (Clinical)
25050 PEACHLAND AVE, SUITE 250
NEWHALL, CA 91321
Community/Behavioral Health
25050 PEACHLAND AVE, 203
NEWHALL, CA 91321
Psychologist (Clinical)
25050 PEACHLAND AVE, SUITE 250
SANTA CLARITA, CA 91321

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1245436369, enumerated as an "individual" on June 25, 2007.

The provider is located at 25050 PEACHLAND AVE SUITE 250 SANTA CLARITA, CA 91321 and the phone number is (661) 430-9300.

Psychologist with taxonomy code 103T00000X.