Individual provider Active NPI

Nichole Renee Gavel, LCSW

  • Clinical Social Worker
  • Nevada City, CA
National Provider Identifier
1205200730
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21013 Issued in CA
Practice address
437 Broad St
Nevada City, CA 95959-2430
Phone
(530) 308-1433
NPI assigned
Nov 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 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 21013 CA Primary

Addresses

Primary practice location

437 Broad St
Nevada City, CA 95959-2430

Mailing address

437 Broad St
Nevada City, CA 95959-2430
Phone (530) 308-1433

Other names 1

  • Nichole Renee Bowden Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
21013CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1205200730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 BROAD ST",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592430",
            "telephone_number": "530-308-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 BROAD ST",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592430",
            "telephone_number": "530-308-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVEL",
        "first_name": "NICHOLE",
        "middle_name": "RENEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "21013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "BOWDEN",
            "middle_name": "RENEE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nevada City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.