Stacey J Nichols Ostebo, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05656600 Issued in NJ

Practice address

9790 Southerton St
Las Vegas, NV 89178-5532

Phone

(208) 681-9503

NPI assigned

Oct 30, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Stacey Nichols Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wise Path Counseling

  • Community/Behavioral Health Agency
  • Cherry Hill, NJ
  • NPI 1770957086
  NPD (past)

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1194079103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9790 SOUTHERTON ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891785532",
            "telephone_number": "208-681-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9790 SOUTHERTON ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891785532",
            "telephone_number": "208-681-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS OSTEBO",
        "first_name": "STACEY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05656600",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8273583-3502",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "8521-C",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "NICHOLS",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rosie Nicholas
• Serena Nicholas, CNIM
• Sheila Nicholas
• Raymond Paul Nicholl, MD
• Lauren V Nicholls
• Alexis L Nichols
• Ann M Nichols, MFT
• Ava Nichols
• Brandon Nichols, DO
• Brittney Shavonte Nichols

• Clinical Social Worker in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; 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.