Nicole Lee Baschleben, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L11301 Issued in OR

Practice address

37 N 6TH St
Cottage Grove, OR 97424-2012

Phone

(541) 623-6053

NPI assigned

Jan 21, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

South Lane Mental Health Services, IncGroup PAC ID 0042544504, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• South Lane Mental Health Services, Inc

  • Community/Behavioral Health Agency
  • Cottage Grove, OR
  • NPI 1306905831
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1235434200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 BIRCH AVE",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974241416",
            "telephone_number": "541-942-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 N 6TH ST",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974242012",
            "telephone_number": "541-623-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASCHLEBEN",
        "first_name": "NICOLE",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-21",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Marie Baker
• Larry D Barkemeyer
• Gerald A Barker, M.D.
• Breyer L Barkman
• Steven G Barnes, QMHA
• Jeffrey Alan Bell, HC
• Bennett Creek Therapy, LLC
• Kitty Berry, RN
• Kerri Beverly, QMHA, PSS
• Ruth J. Bichsel, PH.D.

• Clinical Social Worker in Cottage Grove, OR
• Providers in Cottage Grove, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.