Nichole Tackett, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149021269 Issued in IL

Practice address

6373 N Paulina St # B
Chicago, IL 60660-1645

Phone

(309) 634-5468

NPI assigned

Dec 8, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1575763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1437796539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6373 N PAULINA ST # B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6373 N PAULINA ST # B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601645",
            "telephone_number": "309-634-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "NICHOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-08",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149021269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Tabrizi
• Courtenie Taccolini, LPC
• Alessandra Marinella Tachauer, MD
• Allan Tachauer, MD
• Kyle Tacia, LPC
• Jonathan Tacuri
• Janice F. Taczy, CPNP
• Katherine Azadeh Tadayoni, PHARMD, MPH
• Nigist Abena Taddese, MD
• Funmilayo Tade Adewale, M.D.

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.