Active NPI
Michelle M Nickerson, LICSW
- Clinical Social Worker
- Amesbury, MA
National Provider Identifier
1043336324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 121121
- Practice address
- 12 Market Square
Suite 2
Amesbury, MA 01913 - Phone
- (857) 285-8265
- NPI assigned
- Mar 21, 2007
- Last updated
- May 30, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1369 | NH | |
| Clinical Social Worker | 1041C0700X | 2096 | NH | |
| Clinical Social Worker | 1041C0700X | 121121 | MA | Primary |
Addresses
Primary practice location
12 Market Square
Suite 2
Amesbury, MA 01913
Mailing address
212 Low St
Newburyport, MA 01950-3535
Phone (857) 285-8265
Other practice location 1
99 Hanover St
Manchester, NH 03101-2203
Phone (603) 518-4118
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
| License | State | Type | Specialty |
|---|---|---|---|
| 121121 | MA | MD | Clinical Social Worker |
| 1369 | NH | MD | Physician Assistant |
| 2096 | NH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Finding Solace Counseling LLC | Clinical | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Amesbury, MA
- NPI 1609354299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527638400000",
"number": "1043336324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 LOW ST",
"city": "NEWBURYPORT",
"state": "MA",
"postal_code": "019503535",
"telephone_number": "857-285-8265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 MARKET SQUARE",
"address_2": "SUITE 2",
"city": "AMESBURY",
"state": "MA",
"postal_code": "01913",
"telephone_number": "857-285-8265"
}
],
"practiceLocations": [
{
"address_1": "99 Hanover St",
"address_purpose": "LOCATION",
"city": "Manchester",
"state": "NH",
"postal_code": "031012203",
"country_code": "US",
"telephone_number": "603-518-4118",
"fax_number": "603-668-6260",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NICKERSON",
"first_name": "MICHELLE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2018-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NH",
"license": "1369",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NH",
"license": "2096",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "121121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Amesbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.