Carolyn J. Nicholson, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

20955 Virginia St
Suite B
Southfield, MI 48076-2381

Phone

(248) 219-5493

Fax

(248) 354-3816

NPI assigned

Jun 17, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Baqj Consultants, LLC

  • Community/Behavioral Health Agency
  • Southfield, MI
  • NPI 1063687515
  NPD (past)
• Yvette Hardy Pebble Brook Care Agency Inc

  • Social Worker
  • Inkster, MI
  • NPI 1194212613
  NPD (past)

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1447410071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20955 VIRGINIA ST",
            "address_2": "SUITE B",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762381",
            "telephone_number": "248-219-5493",
            "fax_number": "248-354-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20955 VIRGINIA ST",
            "address_2": "SUITE B",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762381",
            "telephone_number": "248-219-5493",
            "fax_number": "248-354-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "CAROLYN",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "N242108275628",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Qui Nguyen
• Valerie-Thao-Nhu Nguyen
• Madeleine Claire Nicholas, DO
• Karen Nichols, BSW
• Marisa Leigh Nichols, PA-C
• Breanna Nicks
• Nicole Guza Counseling PLLC
• Nicole Rothenberg MD PLLC
• Janae Niedzwiecki
• Jeffrey Nigl, MD

• Clinical Social Worker in Southfield, MI
• Providers in Southfield, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.