Chelsea Diane Nichols

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

X-11505 Issued in NM

Practice address

1025 Hermosa Dr SE
Albuquerque, NM 87108-4312

Phone

(505) 237-0061

Fax

(505) 237-0068

NPI assigned

Jul 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Chelsea Diane Cantrall Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1053929265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12115 LA VISTA GRANDE DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871116708",
            "telephone_number": "505-908-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 HERMOSA DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871084312",
            "telephone_number": "505-237-0061",
            "fax_number": "505-237-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "CHELSEA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "X-11505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHELSEA",
            "last_name": "CANTRALL",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Nguyen
• William Don Nguyen
• Xuan Thanh Nguyen
• Xuan Thuy Thi Nguyen
• Andrea C. Nichol, DO
• Deanna L Nichols, OT
• Janeil F Nichols
• Janet Elizabeth Nichols, M.D.
• Linda Kay Nichols, D.M.D., P.A.
• Patricia Marie Nichols, DOM

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.