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

Active since June 25, 2007Opted out of Medicare · through Jul 3, 2027
25050 PEACHLAND AVE, SUITE 250, SANTA CLARITA, CA 91321(661) 430-9300 Get Directions Write a Review

NPPES record last updated: June 28, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Nicole Phillips Connolly Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICOLE PHILLIPS CONNOLLY PH.D. (NPI 1245436369) is an individual psychologist in Santa Clarita, California, licensed in California (PSY23260) and active in the NPI registry since June 2007. She has opted out of Medicare through July 3, 2027.

NPPES Registry Identity

NPI1245436369
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. NICOLE PHILLIPS CONNOLLYCredential: PH.D.
Location Address25050 PEACHLAND AVE, SUITE 250Santa Clarita, CA 91321-2523
Mailing Address25050 Peachland Ave, Suite 250Santa Clarita, CA 91321-2523 · (661) 430-9300
Sole ProprietorYes
Enumeration DateJune 25, 2007
Last NPPES UpdateJune 28, 2015
NPI 1245436369 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · PSY23260
Definition
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.
25050 PEACHLAND AVE, Santa Clarita, CA 91321

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Nicole Phillips Connolly Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 3, 2023 through July 3, 2027.

Opt-Out Effective DateJuly 3, 2023
Opt-Out In Effect ThroughJuly 3, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Connolly's NPI number?

The NPI number for Nicole Connolly is 1245436369. It was assigned to this individual provider in the NPPES registry on June 25, 2007.

Where is Nicole Connolly located?

Nicole Connolly practices at 25050 Peachland Ave Suite 250, Santa Clarita, CA 91321. The listed phone number is (661) 430-9300.

What is Nicole Connolly's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Nicole Connolly enrolled in Medicare?

No. Nicole Connolly has opted out of Medicare through July 3, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Nicole Connolly was last updated on June 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.