Nickie Lynn Cosgrove, LMSW

Individual provider Active NPI Social Worker · Mountain Home, TN

NPI 1356589667 · NPPES record last updated Jan 23, 2009

Key facts

NPI
1356589667
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
7581 (TN)
Practice address
160 Dogwood Lane
Mountain Home, TN 37684
Phone
(423) 926-1171
Fax
(423) 979-2645
NPI assigned
Jan 23, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7581TNMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 7581 TN Yes

Addresses

Primary practice location

160 Dogwood Lane
Mountain Home, TN 37684

Mailing address

PO Box 4000
Mountain Home, TN 37684-4000
Phone (423) 926-1171

Other providers in Mountain Home, TN

All providers in Mountain Home, TN · Social Worker in Tennessee

Sources for this page

Verify at the official NPI Registry.