Ivy Macnicol, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851121874 Issued in MI

Practice address

601 Bridge St
East Jordan, MI 49727-9421

Phone

(231) 536-2206

Fax

(231) 536-7150

NPI assigned

May 11, 2026

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 27, 2026.

{
    "created_epoch": "1778457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1386572477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 BRIDGE ST",
            "city": "EAST JORDAN",
            "state": "MI",
            "postal_code": "497279421",
            "telephone_number": "231-536-2206",
            "fax_number": "231-536-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BRIDGE ST",
            "city": "EAST JORDAN",
            "state": "MI",
            "postal_code": "497279421",
            "telephone_number": "231-536-2206",
            "fax_number": "231-536-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACNICOL",
        "first_name": "IVY",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-11",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851121874",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MI",
            "license": "20260216",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin King
• Laboratory Corporation of America
• Erika Kelly Lagumina
• Sasha Lash
• Joshua Lewis, RPH
• Nakita Lee Marihugh
• Richard L Mason, PHARMD
• Ryan P McConnell, DO
• Jay McCulloch, RPH
• Amelia McGeorge

• All providers in East Jordan, MI
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.