Nicole E Davis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

078313 Issued in NY

Practice address

159 Millburn Ave Ste 1
Millburn, NJ 07041-1846

Phone

(917) 304-7951

NPI assigned

Oct 26, 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

Medicare fee-for-service enrollment

Enrolled in NY

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 and National Provider Directory roles.

• Jesse Kahn LCSW PLLC

  dba The Gender & Sexuality Therapy Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1396260980
  Medicare reassignment NPD

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1366621302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 FOREST HILL RD",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524518",
            "telephone_number": "917-304-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 MILLBURN AVE STE 1",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411846",
            "telephone_number": "917-304-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "NICOLE",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-26",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "076063-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Alexander Daly, MD
• Helen Danto
• David M. Newman, M.D., LLC
• Monique M Davidoff, MS, OTRL
• Gregory S Davis, PT
• Heather Deeble, O.D.
• Jana Degidio
• Jessica Marisol Del Valle
• Christine M. Delduca, D.M.D.
• Patricia Ann Delgaldo, LCSW

• Clinical Social Worker in Millburn, NJ
• Providers in Millburn, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.