Donna J Nicholas, MSW, LCSW

Individual provider Active NPI Clinical Social Worker · Spencer, IN

NPI 1235115353 · NPPES record last updated Jul 30, 2014

Key facts

NPI
1235115353
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
34001239A (IN)
Practice address
272 N US Highway 231
Spencer, IN 47460-6635
Phone
(812) 829-4871
Fax
(812) 829-0758
NPI assigned
Dec 20, 2005
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Point, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34001239A IN Yes

Addresses

Primary practice location

272 N US Highway 231
Spencer, IN 47460-6635

Mailing address

645 S Rogers St
Bloomington, IN 47403-2353
Phone (812) 339-1691

Other names

  • Donna J Keller Former name

Other providers in Spencer, IN

All providers in Spencer, IN · Clinical Social Worker in Indiana

Sources for this page

Verify at the official NPI Registry.