Nicole Renee Woolery, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1100167 Issued in OH

Practice address

8479 S Mason Montgomery Rd Ste 4
Mason, OH 45040-4023

Phone

(513) 443-2415

Fax

(513) 725-1141

NPI assigned

Dec 14, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Child Focus Inc

  • Community/Behavioral Health Agency
  • Cincinnati, OH
  • NPI 1669438115
  Medicare reassignment NPD

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1285937227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8479 S MASON MONTGOMERY RD STE 4",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450404023",
            "telephone_number": "513-443-2415",
            "fax_number": "513-725-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8479 S MASON MONTGOMERY RD STE 4",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450404023",
            "telephone_number": "513-443-2415",
            "fax_number": "513-725-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLERY",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-14",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S . 0600518",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1100167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0166013",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie Wittman, RN
• Chad Ashton Wolf
• Brian Wollocko, MD
• Shelby Evelyn Wood, MS, OTR/L
• Mary Woods
• Liza Woolston
• Chad R Worz, PHARMD
• Amanda Wright
• Faith Wright
• Deanna Wu, MSN, APRN, PMHNP-BC

• Clinical Social Worker in Mason, OH
• Providers in Mason, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.