Nicole Collins, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

26249 Issued in MN

Practice address

1102 Cloquet Ave
Cloquet, MN 55720-1620

Phone

(218) 499-7000

Fax

(218) 499-7001

NPI assigned

Jan 8, 2021

Last updated

Jan 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Birch and Pine Counseling PLLPGroup PAC ID 9436525482, 5 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Birch & Pine Counseling PLLP

  • Clinical Social Worker
  • Cloquet, MN
  • NPI 1649915281
  Medicare reassignment Care Compare group NPD
• Brightwater Health Dba Human Development Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Duluth, MN
  • NPI 1194790733
  NPD (past)

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1386232841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 CLOQUET AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201620",
            "telephone_number": "218-499-7000",
            "fax_number": "218-499-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 CLOQUET AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201620",
            "telephone_number": "218-499-7000",
            "fax_number": "218-499-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "NICOLE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cloquet Eyecare and Contact Lens Center
• Cloquet Isd 94
• Cloquet Psychological
• Cloquet Psychological LLC
• Stacy Leah Colich
• Richard Lee Colsen
• Community Memorial Hospital Association
• Community Memorial Hospital Association
• Community Memorial Hospital Association
• Community Memorial Hospital Association

• Clinical Social Worker in Cloquet, MN
• Providers in Cloquet, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.