Individual provider Active NPI

Melissa Sue Nichols

  • Clinical Social Worker
  • Hyde Park, UT
National Provider Identifier
1396006003
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8957395-3502 Issued in UT
Practice address
338 W 300 N
Hyde Park, UT 84318-4044
Phone
(435) 774-4113
Fax
(435) 535-3197
NPI assigned
May 30, 2012
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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 8957395-3502 UT Primary

Addresses

Primary practice location

338 W 300 N
Hyde Park, UT 84318-4044

Mailing address

338 W 300 N
Hyde Park, UT 84318-4044
Phone (435) 774-4113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8957395-3502UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Melissa Nichols Psychotherapy Clinical CurrentSince Sep 10, 2023 Accepting new patients

Locations

338 W 300 N
Hyde Park, UT 84318
Phone (435) 744-4113

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

NPI Registry JSON

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1396006003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 W 300 N",
            "city": "HYDE PARK",
            "state": "UT",
            "postal_code": "843184044",
            "telephone_number": "435-774-4113",
            "fax_number": "435-535-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 W 300 N",
            "city": "HYDE PARK",
            "state": "UT",
            "postal_code": "843184044",
            "telephone_number": "435-774-4113",
            "fax_number": "435-535-3197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MELISSA",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8957395-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyde Park, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.