Nichole L Jardine LCSW PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8977595-3501 Issued in UT

Legal business name

NICHOLE L JARDINE LCSW PLLC

Practice address

5991 Bell St SE
Tumwater, WA 98501-5355

Phone

(435) 232-7995

Fax

(435) 753-9521

NPI assigned

Jul 13, 2016

Organization subpart

No

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

Authorized official

Name

Nichole L Jardine, LCSWNPI 1003266206

Title

Owner

Phone

(435) 213-3583

Specialties & licenses 1

Addresses

Other names 1

• Nicky Jardine Other name

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nichole L Jardine, LCSW

  • Clinical Social Worker
  • Tumwater, WA
  • NPI 1003266206

  UT

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1376996421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5991 BELL ST SE",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985015355",
            "telephone_number": "435-232-7995",
            "fax_number": "435-753-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5991 BELL ST SE",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985015355",
            "telephone_number": "435-232-7995",
            "fax_number": "435-753-9521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 W 465 N",
            "address_2": "Suite 130",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "UT",
            "postal_code": "843328003",
            "country_code": "US",
            "telephone_number": "435-213-3583",
            "fax_number": "435-753-9521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NICHOLE L JARDINE LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-13",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "JARDINE",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-213-3583",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8977595-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nicky Jardine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Nicky Jardine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sue Newcomb, L'AC
• Erin Newgard
• Renee Newton, MS
• Nha H Nguyen, OD
• Thuy-an Tran Nguyen, PHARM. D.
• Nell Elizabeth Nichols, BCBA
• Mary Njogu
• Courtney Joann Noble, CPS, HCA
• Nicole Alexandria Nomic
• Miriam Catherine Nordquist, RN

• Clinical Social Worker in Tumwater, WA
• Providers in Tumwater, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.