Individual provider Active NPI

William G Nick, LCSW

  • Clinical Social Worker
  • Sturgeon Bay, WI
National Provider Identifier
1093781536
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
39205900 Issued in WI
Practice address
620 N 12TH Ave
Sturgeon Bay, WI 54235-1249
Phone
(920) 743-9954
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 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 39205900 WI Primary

Addresses

Primary practice location

620 N 12TH Ave
Sturgeon Bay, WI 54235-1249

Mailing address

620 N 12TH Ave
Sturgeon Bay, WI 54235-1249
Phone (920) 743-9954

Other identifiers 1

IdentifierTypeStateIssuer
39205900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 5, 2015 through Jan 5, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
39205900WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1093781536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N 12TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351249",
            "telephone_number": "920-743-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N 12TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351249",
            "telephone_number": "920-743-9954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICK",
        "first_name": "WILLIAM",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "39205900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39205900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sturgeon Bay, WI

Sources for this page

Verify at the official NPI Registry.