Kaitlyn E Nicholson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904016773 Issued in VA

Practice address

9202 Center Oak CT
Mechanicsville, VA 23116-2744

Phone

(804) 207-6737

NPI assigned

Dec 15, 2020

Last updated

Aug 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, VA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

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.

• Commonwealth Counseling Associates Inc

  dba LifeStance Health

  • Clinical Psychologist
  • Mechanicsville, VA
  • NPI 1851345805

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD
• Jennifer Ufko, LCSW, PLLC

  • Clinical Social Worker
  • Hauppauge, NY
  • NPI 1629471552
  Medicare reassignment NPD
• Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Amenia, NY
  • NPI 1568526838
  Medicare reassignment NPD
• Sun River Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Peekskill, NY
  • NPI 1619969458
  NPD

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1396331229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 MAPLE RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117543127",
            "telephone_number": "347-723-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9202 CENTER OAK CT",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162744",
            "telephone_number": "804-207-6737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 Maple Rd",
            "address_purpose": "LOCATION",
            "city": "Kings Park",
            "state": "NY",
            "postal_code": "117543127",
            "country_code": "US",
            "telephone_number": "347-723-8761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "KAITLYN",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "35145",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "107673",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904016773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Next Chapter Counseling, LLC
• Anh Phuong Nguyen, DDS
• Hung Tien Nguyen
• Kari Huong Nguyen, M.D.
• Caroline Nice, M.S., CCC-SLP
• Brian L. Niedermayer, OT
• Monica Nieves, APRN FNP
• Rebecca Kiren Nightingale, P.A.
• Hasamone April Nimjareansuk, DO
• Dan Arthur Njieumegnah Aghomo

• Clinical Social Worker in Mechanicsville, VA
• Providers in Mechanicsville, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.