Individual provider Active NPI

Stephen H. Nicholas, MSW, LCSW

  • Clinical Social Worker
  • Carson City, NV
National Provider Identifier
1174790786
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5834-C Issued in NV
Practice address
407 N Walsh St
Carson City, NV 89701-4268
Phone
(775) 315-9738
Fax
(888) 891-3191
NPI assigned
May 13, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

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 5834-C NV Primary

Addresses

Primary practice location

407 N Walsh St
Carson City, NV 89701-4268

Mailing address

407 N Walsh St
Carson City, NV 89701-4268
Phone (775) 315-9738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20150505000915 NV Practitioner - Clinical Social Worker 3476872946 Practice locations: Carson City, NV

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

407 N Walsh St
Carson City, NV 89701-4268

623 W Washington St
Suite a
Carson City, NV 89703-3837
Phone (775) 365-9738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5834-CNVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1174790786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 N WALSH ST",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897014268",
            "telephone_number": "775-315-9738",
            "fax_number": "888-891-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N WALSH ST",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897014268",
            "telephone_number": "775-315-9738",
            "fax_number": "888-891-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "STEPHEN",
        "middle_name": "H.",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "5834-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.