Individual provider Active NPI

Jennifer Dawn Nicoll, LCSW

  • Clinical Social Worker
  • Mandeville, LA
National Provider Identifier
1225156953
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8009 Issued in LA
Practice address
2810 E Causeway Approach
Mandeville, LA 70448-3502
Phone
(985) 875-2340
NPI assigned
Mar 27, 2007
Last updated
Oct 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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 8009 LA Primary

Addresses

Primary practice location

2810 E Causeway Approach
Mandeville, LA 70448-3502

Mailing address

2810 E Causeway Approach
Mandeville, LA 70448-3502
Phone (985) 875-2340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20110209000643 LA Practitioner - Clinical Social Worker 4284814146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3000

1516 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3470

71380 Hwy 21
Covington, LA 70433-7245
Phone (985) 661-3534

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8009LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Oct 1, 2012 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Clinic LLC CurrentSince Oct 1, 2012 Accepting new patients

Locations

2810 E Causeway Approach
Mandeville, LA 70448
Phone (985) 674-9400

1514 Jefferson Hwy
New Orleans, LA 70121

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1225156953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 E CAUSEWAY APPROACH",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483502",
            "telephone_number": "985-875-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 E CAUSEWAY APPROACH",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483502",
            "telephone_number": "985-875-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLL",
        "first_name": "JENNIFER",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "8009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

Verify at the official NPI Registry.