NICOLE AYSSA LOLLIS LCMHC
NPI 1851816193
Counselor - Mental Health in Kernersville, NC

Q: What is Nicole Lollis's NPI number?

The NPI number for Nicole Lollis is 1851816193. It was assigned to this individual provider in the NPPES registry on August 8, 2017. The provider is also known as Nicole Ayssa Hernandez Lcmhc.

Q: What is Nicole Lollis's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nicole Lollis was last updated on October 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.

Active since August 08, 2017PECOS Enrolled

1730 KERNERSVILLE MEDICAL PKWY STE 101, KERNERSVILLE, NC 27284(336) 564-4950(336) 564-4959 Get Directions Write a Review

NPPES record last updated: October 29, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 10, 2023, Nov 6, 2023, Jul 5, 2022 and 1 more (4 updates tracked since 2017).

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About Nicole Ayssa Lollis Lcmhc NPPES

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

NICOLE AYSSA LOLLIS LCMHC (NPI 1851816193) is an individual mental health provider in Kernersville, North Carolina, licensed in North Carolina (13006) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Winston Salem, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1851816193

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameNICOLE AYSSA LOLLISCredential: LCMHC

Location Address1730 KERNERSVILLE MEDICAL PKWY STE 101Kernersville, NC 27284-7198

Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (336) 564-4950 · Fax (336) 564-4959

Phone(336) 564-4950

Fax(336) 564-4959

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateAugust 8, 2017

Last NPPES UpdateOctober 29, 20244 updates tracked since enumeration

NPPES CertifiedOctober 29, 2024

✔ NPI 1851816193 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in NC · 13006

1730 KERNERSVILLE MEDICAL PKWY STE 101, Kernersville, NC 27284

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Other Names 1

Former Name (1)Nicole Ayssa Hernandez Lcmhc

Secondary Practice Location 1

Location 1450 W Hanes Mill Rd Ste 224Winston Salem, NC 27105-7404 · Phone (336) 546-5003

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Oscar Health Plan of North Carolina, Inc, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Ayssa Lollis Lcmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1153857974

PECOS Enrollment IDI20241204000136

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

MR. TYWAN J LINDSEY LCSW

Social Worker (Clinical)