Nichelle Dillon, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

5123 W 98TH St Ste 1072
Minneapolis, MN 55437-2040

Phone

(612) 263-7880

Fax

(779) 201-7798

NPI assigned

Nov 4, 2015

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, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pathway Virtu-Health

  • Family Nurse Practitioner
  • Shoreview, MN
  • NPI 1073134284
  NPD (past)

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1417320052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 LYNDALE AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033380",
            "telephone_number": "800-336-5973",
            "fax_number": "612-234-4689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5123 W 98TH ST STE 1072",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554372040",
            "telephone_number": "612-263-7880",
            "fax_number": "779-201-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "NICHELLE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Dille
• Martha E Dille, M.S. L.P.
• Bridget Dillon, MD
• Charlie Dillon
• Kimberly Williams Dillon, LADC
• Tara Colleen Dillon, RN
• Robin Dilts
• Nicholas Mario Dilullo, PA-C
• Harrison Parry Dilworth IV, MD
• Jeanne M Dimeglio, LICSW

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, 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 10, 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.
• 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.