# INTEGRATIVE NURSE PRACTITIONER IN PSYCHIATRY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639985435
- **Authorized official:** MRS. NICHOLE MARIE MCLEOD PMHNP (OWNER)
- **Authorized official phone:** (716) 578-5788

## Contact information

- **Practice address:** 5775 BROADWAY ST, LANCASTER, NY 14086-2456
- **Practice address phone:** (716) 544-8848
- **Practice address fax:** (888) 612-0831
- **Mailing address:** 81 DARTWOOD DR, CHEEKTOWAGA, NY 14227-3121
- **Mailing address phone:** (716) 578-5788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/06/2024
- **Last updated:** 10/28/2025