Nicole Conrad Collison, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16192 Issued in MD

Practice address

7837 Harold Rd
Baltimore, MD 21222-3302

Phone

(410) 382-7312

NPI assigned

Aug 6, 2020

Last updated

Aug 6, 2020By 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

Other names 1

• Miss Nicole Elizabeth Conrad Former name

Medicare fee-for-service enrollment

Enrolled in MD

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidemark Intervention ServicesGroup PAC ID 7911317441, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Tidemark Intervention Services

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1720595242
  Medicare reassignment Care Compare group NPD
• Tidemark Intervention Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1174235691
  NPD
• Tidemark Intervention Services

  • Counselor
  • Baltimore, MD
  • NPI 1437818770
  NPD (past)

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1447860143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7837 HAROLD RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212223302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7837 HAROLD RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212223302",
            "telephone_number": "410-382-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLISON",
        "first_name": "NICOLE",
        "middle_name": "CONRAD",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "16192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "CONRAD",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Simone Collins
• Victoria Collins
• Yvonne Annette Collins
• Aleisha Collinson-Streng
• Danielle Aline Collison, LCSW-C
• Kaylin Collymore-Bey
• Maurizio Colognesi-Capogrossi, M.D.
• Paul M. Colombani, M.D.
• Jeidimar Colon Miranda
• Krista Marie Colopinto, CRNP

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; 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.