Skylar Jordan Nichols, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2022004433 Issued in MO

Practice address

1129 Macklind Ave
Saint Louis, MO 63110-1440

Phone

(314) 534-0200

NPI assigned

Jul 20, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• St. Louis Behavioral Medicine Institute Inc

  • Psychologist
  • Saint Louis, MO
  • NPI 1487732335
  Medicare reassignment NPD
• St. Louis Behavioral Medicine Institute Inc

  • Mental Health Counselor
  • Fairview Heights, IL
  • NPI 1952169179
  NPD

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

{
    "created_epoch": "1563580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779667200000",
    "number": "1093368805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6202 ARTHUR AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631392017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 MACKLIND AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101440",
            "telephone_number": "314-534-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "SKYLAR",
        "middle_name": "JORDAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-20",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200002677",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.024865",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW125947",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2022004433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay C Nichols, LPC
• Lynn Rae Nichols, M.S CCC-SLP, M. ED
• Melanie Nichols, PH.D.
• Nicole K Nichols, ANP
• Rebecca Nichols, RN
• Steven H Nichols, MD
• Adam Nicholson, MSW
• Mikeya Nicholson, MA, LPC
• Susan Kay Nicholson, P.A.
• Timothy I Nicholson, PLPC

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.