Individual provider Active NPI

Nicole C Davis, MSW, LCSW

  • Clinical Social Worker
  • Bear, DE
National Provider Identifier
1376415810
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
Q1-0001588 Issued in DE
Practice address
1107 Quintilio Dr
Bear, DE 19701
Phone
(302) 276-9590
NPI assigned
Sep 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 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 Q1-0001588 DE Primary

Addresses

Primary practice location

1107 Quintilio Dr
Bear, DE 19701

Mailing address

135 Auckland Dr
Newark, DE 19702-4257
Phone (856) 905-1510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20260102001245 DE Practitioner - Clinical Social Worker 3678069218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20 Penn Mart Ctr
Pm215
New Castle, DE 19720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
Q1-0001588DEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Diversity Care NP Group LLC Clinical CurrentSince Dec 1, 2025 Accepting new patients

Locations

1107 Quintilio Dr
Bear, DE 19701
Phone (302) 276-9590

1107 Quintilio Dr
Bear, DE 19701
Phone (302) 276-9590

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": "1758585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1376415810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 AUCKLAND DR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197024257",
            "telephone_number": "856-905-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 QUINTILIO DR",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "19701",
            "telephone_number": "302-276-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "NICOLE",
        "middle_name": "C",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-23",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0001588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bear, DE

Sources for this page

Verify at the official NPI Registry.