Nichole L Jardine, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61179889 Issued in WA

Practice address

5991 Bell St SE
Tumwater, WA 98501-5355

Phone

(435) 213-3583

NPI assigned

Jun 17, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678
  Medicare reassignment Care Compare group NPD
• Nichole L Jardine LCSW PLLC

  • Clinical Social Worker
  • Tumwater, WA
  • NPI 1376996421

  UT

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1003266206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5991 BELL ST SE",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985015355",
            "telephone_number": "435-213-3583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5991 BELL ST SE",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985015355",
            "telephone_number": "435-213-3583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 W 465 N",
            "address_2": "Suite 130",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "UT",
            "postal_code": "843328003",
            "country_code": "US",
            "telephone_number": "435-213-3583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "522 W Riverside Ave Ste N",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992010580",
            "country_code": "US",
            "telephone_number": "435-232-7995",
            "fax_number": "435-752-7802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARDINE",
        "first_name": "NICHOLE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-17",
        "last_updated": "2022-08-19",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61179889",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8977595-3501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Providence",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "545 W 465 N",
            "address_2": "Suite 130",
            "city": "Providence",
            "state": "UT",
            "country_code": "US",
            "postal_code": "843328003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Irene Iwenofu
• J&K Healthcare Enterprises Inc
• Lacey Jackson, LMP
• Susan R. Renee Jackson, LMP
• Sara E James
• Kirk Jarman, P.A.
• Angelina H. Jefferson
• Christopher Scott Jefferson, RN
• Jennifer Koch, Psy.D., PLLC
• Douglas N. Jeske, O.D.

• Clinical Social Worker in Tumwater, WA
• Providers in Tumwater, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.