Active NPI
Angela Lynn Nickum, LSW
- Social Worker
- Pittsburgh, PA
National Provider Identifier
1114736170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW139757
- Practice address
- 2001 Kinvara Dr
Pittsburgh, PA 15237-3801 - Phone
- (412) 401-3636
- NPI assigned
- Jan 4, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW139757 | PA | Primary |
Addresses
Primary practice location
2001 Kinvara Dr
Pittsburgh, PA 15237-3801
Mailing address
301 Caledonia PL
Cranberry Township, PA 16066-3407
Phone (412) 401-3636
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 |
|---|---|---|---|
| SW139757 | PA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1735948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735948800000",
"number": "1114736170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 CALEDONIA PL",
"city": "CRANBERRY TOWNSHIP",
"state": "PA",
"postal_code": "160663407",
"telephone_number": "412-401-3636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 KINVARA DR",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152373801",
"telephone_number": "412-401-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICKUM",
"first_name": "ANGELA",
"middle_name": "LYNN",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-04",
"last_updated": "2025-01-04",
"certification_date": "2025-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "SW139757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.