Individual provider Active NPI

Chavis Lee Nicholls, LCSW, LAC

  • Clinical Social Worker
  • Billings, MT
National Provider Identifier
1356694772
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2352 Issued in MT
Practice address
1220 Avenue C Apt F
Billings, MT 59102-3200
Phone
(066) 981-6194
NPI assigned
Oct 23, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2352 MT Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1378 MT

Addresses

Primary practice location

1220 Avenue C Apt F
Billings, MT 59102-3200

Mailing address

1220 Avenue C Apt F
Billings, MT 59102-3200
Phone (066) 981-6194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20240304001809 MT Practitioner - Clinical Social Worker 2668816398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1220 Ave C
Apt F
Billings, MT 59102-3200
Phone (406) 698-1619

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1378MTMDAddiction (Substance Use Disorder) Counselor
2352MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Confidential Counseling and Consultation LLC Clinical CurrentSince Dec 17, 2023 Accepting new patients

Locations

1220 Avenue C
Apt F
Billings, MT 59102
Phone (406) 855-0013

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1356694772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 AVENUE C APT F",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591023200",
            "telephone_number": "066-981-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 AVENUE C APT F",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591023200",
            "telephone_number": "066-981-6194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLLS",
        "first_name": "CHAVIS",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "LCSW, LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-23",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "2352",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "1378",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.