Individual provider Active NPI

Nicole Bushnell, LMSW

  • Clinical Social Worker
  • Laurel, MD
National Provider Identifier
1407551609
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26196 Issued in MD
Practice address
14440 Cherry Lane CT Ste 208
Laurel, MD 20707-4946
Phone
(301) 604-1458
NPI assigned
Apr 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 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 26196 MD Primary

Addresses

Primary practice location

14440 Cherry Lane CT Ste 208
Laurel, MD 20707-4946

Mailing address

14440 Cherry Lane CT Ste 208
Laurel, MD 20707-4946
Phone (301) 604-1458

Other practice location 1

1209 N East St Ste 106
Frederick, MD 21701-4662
Phone (240) 788-2632

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26196MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1407551609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14440 CHERRY LANE CT STE 208",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074946",
            "telephone_number": "301-604-1458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14440 CHERRY LANE CT STE 208",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074946",
            "telephone_number": "301-604-1458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1209 N East St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217014662",
            "country_code": "US",
            "telephone_number": "240-788-2632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSHNELL",
        "first_name": "NICOLE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-05",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "26196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.