Nichole Jennifer Carr, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1700654-S Issued in OH

Practice address

867 Dufour LN
Oxford, OH 45056-8514

Phone

(765) 914-9986

NPI assigned

Aug 5, 2007

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 names 1

• Nichole Jennifer Dudley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1306037403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "867 DUFOUR LN",
            "city": "OXFORD",
            "state": "OH",
            "postal_code": "450568514",
            "telephone_number": "765-914-9986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 DUFOUR LN",
            "city": "OXFORD",
            "state": "OH",
            "postal_code": "450568514",
            "telephone_number": "765-914-9986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "NICHOLE",
        "middle_name": "JENNIFER",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006156A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1700654-S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "DUDLEY",
            "middle_name": "JENNIFER",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jodi L Calkins, NP
• Susan Rose Callan, M.S.W.
• Julie Campbell-Ruggaard, PH.D.
• Paul J. Cangemi, M.D.
• Jeffery A Carpenter, D.C.
• Kimberly Carter, RN
• Patrick Caruso
• Tiffany Cassell
• Grace Cassidy, PT, DPT
• Ccare Counseling LLC

• All providers in Oxford, OH
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.