Individual provider Active NPI

Nicole Marie Dollman, LCSW

  • Clinical Social Worker
  • Garden City, NY
National Provider Identifier
1205015666
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0445201 Issued in NY
Practice address
300 Garden City PLZ
Suite 400
Garden City, NY 11530-3302
Phone
(516) 248-0006
Fax
(516) 248-0603
NPI assigned
Nov 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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 R0445201 NY Primary

Addresses

Primary practice location

300 Garden City PLZ
Suite 400
Garden City, NY 11530-3302

Mailing address

300 Garden City PLZ
Suite 400
Garden City, NY 11530-3302
Phone (516) 248-0006

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

LicenseStateTypeSpecialty
R0445201NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Psychological Services PLLC PastSince Aug 19, 2011 Accepting new patients
Long Island Psychological Services Company Past Accepting new patients

Organizations & group practices 2

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": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1205015666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GARDEN CITY PLZ",
            "address_2": "SUITE 400",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303302",
            "telephone_number": "516-248-0006",
            "fax_number": "516-248-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GARDEN CITY PLZ",
            "address_2": "SUITE 400",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303302",
            "telephone_number": "516-248-0006",
            "fax_number": "516-248-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLLMAN",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0445201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.