NPIMap

Individual provider Active NPI

Nicole Danielle Watts, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1225193089
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113387 Issued in CA
Practice address
6762 Lexington Ave
Los Angeles, CA 90038-1217
Phone
(323) 380-7590
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C005250 NC
Case Manager/Care Coordinator 171M00000X CA
Clinical Social Worker 1041C0700X 113387 CA Primary

Addresses

Primary practice location

6762 Lexington Ave
Los Angeles, CA 90038-1217

Mailing address

6762 Lexington Ave
Los Angeles, CA 90038-1217
Phone (323) 380-7590

Other identifiers 1

IdentifierTypeStateIssuer
6106453MedicaidNC

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
113387CAMDClinical Social Worker
C005250NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Metrolina AIDS Project, Inc. Past Accepting new patients
Triumph LLC Clinical Past Accepting new patients
Carolina Behavioral Care, P.a. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1225193089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6762 LEXINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900381217",
            "telephone_number": "323-380-7590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6762 LEXINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900381217",
            "telephone_number": "323-380-7590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "NICOLE",
        "middle_name": "DANIELLE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005250",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "113387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106453",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.