Active NPI
Mary Nickel-Nguy, MSSW, LICSW
- Clinical Social Worker
- North Highlands, CA
National Provider Identifier
1417401910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 77775
- Practice address
- 4815 Watt Ave
North Highlands, CA 95660-5108 - Phone
- (916) 569-8484
- NPI assigned
- Aug 12, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 77775 | CA | Primary |
| Clinical Social Worker | 1041C0700X | LW 60330023 | WA |
Addresses
Primary practice location
4815 Watt Ave
North Highlands, CA 95660-5108
Mailing address
1860 Howe Ave Ste 440
Sacramento, CA 95825-1098
Phone (916) 569-8484
Other practice location 1
1600 E Jefferson St
Suite 600
Seattle, WA 98122-5698
Phone (206) 215-4545
Other practice location 2
3065 Freeport Blvd Ste 8
Sacramento, CA 95818-4347
Phone (206) 491-9710
Other names 1
- Ms. Mary Nguy
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
| License | State | Type | Specialty |
|---|---|---|---|
| LW 60330023 | WA | MD | Clinical Social Worker |
| 77775 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764633600000",
"number": "1417401910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 HOWE AVE STE 440",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958251098",
"telephone_number": "916-569-8484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4815 WATT AVE",
"city": "NORTH HIGHLANDS",
"state": "CA",
"postal_code": "956605108",
"telephone_number": "916-569-8484"
}
],
"practiceLocations": [
{
"address_1": "1600 E Jefferson St",
"address_2": "Suite 600",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981225698",
"country_code": "US",
"telephone_number": "206-215-4545",
"fax_number": "206-215-4550",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3065 Freeport Blvd Ste 8",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "958184347",
"country_code": "US",
"telephone_number": "206-491-9710",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NICKEL-NGUY",
"first_name": "MARY",
"name_prefix": "Ms.",
"credential": "MSSW, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-12",
"last_updated": "2025-12-02",
"certification_date": "2025-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "77775",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW 60330023",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "NGUY",
"prefix": "MS.",
"credential": "MSSW, LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in North Highlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.