Individual provider Active NPI

Nicole Marie Klutz

  • Clinical Social Worker
  • Hickory, NC
National Provider Identifier
1336784958
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C016127 Issued in NC
Practice address
106 3Rd Ave NE
Hickory, NC 28601-5014
Phone
(828) 322-9130
Fax
(828) 322-7890
NPI assigned
Nov 7, 2019
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C016127 NC Primary

Addresses

Primary practice location

106 3Rd Ave NE
Hickory, NC 28601-5014

Mailing address

106 3Rd Ave NE
Hickory, NC 28601-5014
Phone (828) 322-9130

Other names 1

  • Nicole K McManus Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20240102000058 NC Practitioner - Clinical Social Worker 7416385653 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C016127NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Counseling Group, P.a. Multi-Specialty CurrentSince Nov 9, 2023 Accepting new patients

Locations

106 3rd Ave NE
Hickory, NC 28601
Phone (828) 322-8736

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1336784958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 3RD AVE NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015014",
            "telephone_number": "828-322-9130",
            "fax_number": "828-322-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 3RD AVE NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015014",
            "telephone_number": "828-322-9130",
            "fax_number": "828-322-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUTZ",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MCMANUS",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.