NICOLE PAN LMHC
NPI 1790077519
Counselor - Mental Health in Amityville, NY

Active since May 12, 2011Opted out of Medicare · through Apr 1, 2028
21 GREENE AVE, SUITE 205, AMITYVILLE, NY 11701(631) 637-0579 Get Directions Write a Review

NPPES record last updated: July 13, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Nicole Pan Lmhc NPPES

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

NICOLE PAN LMHC (NPI 1790077519) is an individual mental health provider in Amityville, New York and active in the NPI registry since May 2011. She has opted out of Medicare through April 1, 2028.

NPPES Registry Identity

NPI1790077519
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameNICOLE PANCredential: LMHC
Location Address21 GREENE AVE, SUITE 205Amityville, NY 11701-2943
Mailing AddressPo Box 1245Farmingdale, NY 11735-0855
Sole ProprietorYes
Enumeration DateMay 12, 2011
Last NPPES UpdateJuly 13, 2015
NPI 1790077519 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
21 GREENE AVE, Amityville, NY 11701

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Nicole Pan Lmhc 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 April 1, 2024 through April 1, 2028.

Opt-Out Effective DateApril 1, 2024
Opt-Out In Effect ThroughApril 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 2

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

Community/Behavioral Health
21 GREENE AVE
AMITYVILLE, NY 11701
Counselor (Mental Health)
21 GREENE AVE, SUITE 205
AMITYVILLE, NY 11701

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 Pan's NPI number?

The NPI number for Nicole Pan is 1790077519. It was assigned to this individual provider in the NPPES registry on May 12, 2011.

Where is Nicole Pan located?

Nicole Pan practices at 21 Greene Ave Suite 205, Amityville, NY 11701. The listed phone number is (631) 637-0579.

What is Nicole Pan's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Nicole Pan enrolled in Medicare?

No. Nicole Pan has opted out of Medicare through April 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Nicole Pan accept?

Health plans from Blue Cross and Blue Shield of NC and Providence Health Plan list Nicole Pan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nicole Pan was last updated on July 13, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.