Individual provider Active NPI

Nicole M Wells-Cimmino, LCSW

  • Clinical Social Worker
  • West Orange, NJ
National Provider Identifier
1013269133
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SL05501600 Issued in NJ
Practice address
1 Hunterdon Rd
West Orange, NJ 07052-1603
Phone
(862) 216-3935
Fax
(973) 243-0989
NPI assigned
Oct 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SL05501600 NJ Primary

Addresses

Primary practice location

1 Hunterdon Rd
West Orange, NJ 07052-1603

Mailing address

1 Hunterdon Rd
West Orange, NJ 07052-1603
Phone (862) 216-3935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210304001225 FL Practitioner - Clinical Social Worker 9830505577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centerstone of Tennessee, Inc.Group PAC ID 9739088113, 114 clinicians

Practice addresses (Care Compare)

7011 A C Skinner Pkwy
Suite 155
Jacksonville, FL 32256-6954
Phone (904) 431-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL05501600NJMDClinical Social Worker

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1013269133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HUNTERDON RD",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521603",
            "telephone_number": "862-216-3935",
            "fax_number": "973-243-0989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HUNTERDON RD",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521603",
            "telephone_number": "862-216-3935",
            "fax_number": "973-243-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS-CIMMINO",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL05501600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.