Nicole Buccalo, LLMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801102176 Issued in MI

Practice address

1600 Porter St
Detroit, MI 48216-1936

Phone

(248) 302-1051

NPI assigned

Jan 25, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1184122152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25529 PARKWOOD DR",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701749",
            "telephone_number": "248-302-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PORTER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482161936",
            "telephone_number": "248-302-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCALO",
        "first_name": "NICOLE",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-25",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801102176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristyn Bryson
• Dawn Brzozowski, RN
• Andrea Celia Brzys, FNP
• Bubbles Transportation Company LLC
• Jordan Bucan, PA
• Rachel H Buccellato
• Julie Ann Buch, M.D.
• Colleen Buchan
• Anquella Eunise Buchanan, M.A. LLPC
• Kahlilah Buchanan

• Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; 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.