Individual provider Active NPI

Nicole Therese Baucum, LCSW

  • Clinical Social Worker
  • Richmond, VA
National Provider Identifier
1043143613
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904015541 Issued in VA
Practice address
1607 Georgia Ave
Richmond, VA 23220-6805
Phone
(540) 940-3203
NPI assigned
Jun 4, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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 0904015541 VA Primary

Addresses

Primary practice location

1607 Georgia Ave
Richmond, VA 23220-6805

Mailing address

1607 Georgia Ave
Richmond, VA 23220-6805
Phone (540) 940-3203

Other practice location 1

901 N Glebe Rd Fl 5
Arlington, VA 22203-1853
Phone (323) 205-7088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904015541VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1780531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1043143613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 GEORGIA AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232206805",
            "telephone_number": "540-940-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 GEORGIA AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232206805",
            "telephone_number": "540-940-3203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 N Glebe Rd Fl 5",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222031853",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "fax_number": "833-419-0181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUCUM",
        "first_name": "NICOLE",
        "middle_name": "THERESE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-04",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904015541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.