Nicole Phelan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC17380 Issued in ME

Practice address

24 Miecaskly Dr
New Gloucester, ME 04260-4670

Phone

(207) 774-3570

NPI assigned

Aug 10, 2016

Last updated

Oct 9, 2024By the provider in NPPES

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

Practice roles

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

• Nicole Kay Phelan, LLC

  • Clinical Social Worker
  • New Gloucester, ME
  • NPI 1336034271
  NPD Authorized official

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1447704275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MIECASKLY DR",
            "city": "NEW GLOUCESTER",
            "state": "ME",
            "postal_code": "042604670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MIECASKLY DR",
            "city": "NEW GLOUCESTER",
            "state": "ME",
            "postal_code": "042604670",
            "telephone_number": "207-774-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC17380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Kay Phelan, LLC
• Opportunity Farm for Boys & Girls
• Cassandra Pastorelli, OTR/L
• Paul J Balzer, MD
• Briannah Peaslee
• Ashley D Picoraro, PT, DPT
• Pine Tree Home Health Care Inc.
• Kathleen L Plante
• Nancy Risher Porter, OTR/L
• Wendy Susan Ray, LCSW

• Clinical Social Worker in New Gloucester, ME
• Providers in New Gloucester, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.