Active NPI
Nikki Delisle
- Clinical Social Worker
- Leominster, MA
National Provider Identifier
1245613355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 26 Main St
Leominster, MA 01453-5548 - Phone
- (978) 840-4549
- NPI assigned
- Jul 7, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
26 Main St
Leominster, MA 01453-5548
Mailing address
80 Erdman Way
Suite 208
Leominster, MA 01453-1840
Other practice location 1
80 Erdman Way
Suite 208
Leominster, MA 01453-1840
Phone (978) 870-1840
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SB Transitional Sub, LLC | Past | Accepting new patients | |
| South Bay Mental Health Center, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Brockton, MA
- NPI 1962091173
-
dba South Bay Community Services
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Brockton, MA
- NPI 1023096864
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1245613355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 ERDMAN WAY",
"address_2": "SUITE 208",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014531840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 MAIN ST",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014535548",
"telephone_number": "978-840-4549"
}
],
"practiceLocations": [
{
"address_1": "80 Erdman Way",
"address_2": "Suite 208",
"address_purpose": "LOCATION",
"city": "Leominster",
"state": "MA",
"postal_code": "014531840",
"country_code": "US",
"telephone_number": "978-870-1840",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DELISLE",
"first_name": "NIKKI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-07",
"last_updated": "2020-10-26",
"certification_date": "2020-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leominster, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.