Individual provider Active NPI

Nikki Allen Dyer, MED, MSW, LCSW-C

  • Clinical Social Worker
  • Salisbury, MD
National Provider Identifier
1184501637
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19685 Issued in MD
Practice address
1411 Wesley Dr
Salisbury, MD 21801-7149
Phone
(410) 642-4011
NPI assigned
Aug 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 19685 MD Primary

Addresses

Primary practice location

1411 Wesley Dr
Salisbury, MD 21801-7149

Mailing address

24880 Nanticoke Rd
Quantico, MD 21856-2058
Phone (804) 338-7764

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20260511000802 MD Practitioner - Clinical Social Worker 7416425285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evolve Mental WellnessGroup PAC ID 6608266846, 21 clinicians

Practice addresses (Care Compare)

1411 Wesley Dr
Salisbury, MD 21801-7149
Phone (410) 642-4011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
19685MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Mental Wellness Mental Health CurrentSince Aug 25, 2025 Accepting new patients

Locations

1411 Wesley Dr
Salisbury, MD 21801
Phone (410) 642-4011

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1184501637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24880 NANTICOKE RD",
            "city": "QUANTICO",
            "state": "MD",
            "postal_code": "218562058",
            "telephone_number": "804-338-7764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 WESLEY DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017149",
            "telephone_number": "410-642-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "NIKKI",
        "middle_name": "ALLEN",
        "credential": "MED, MSW, LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "19685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.