Individual provider Active NPI

Marco Antonio Nozicka, LCSW

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1457585820
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C006326 Issued in NC
Practice address
6881 Raeford Rd
Fayetteville, NC 28304-2630
Phone
(910) 423-6200
Fax
(910) 429-0800
NPI assigned
May 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C006326 NC Primary
Clinical Social Worker 1041C0700X 149.001824 IL

Addresses

Primary practice location

6881 Raeford Rd
Fayetteville, NC 28304-2630

Mailing address

6881 Raeford Road
Fayetteville, NC 28304
Phone (910) 423-6200

Other names 1

  • Marco Antonio Nozicka Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.001824ILMDClinical Social Worker
C006326NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Day Counseling Center, Inc., P.C. PastSince Oct 8, 2004 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242172800000",
    "number": "1457585820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6881 RAEFORD ROAD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-423-6200",
            "fax_number": "910-429-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6881 RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283042630",
            "telephone_number": "910-423-6200",
            "fax_number": "910-429-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOZICKA",
        "first_name": "MARCO",
        "middle_name": "ANTONIO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-13",
        "last_updated": "2009-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006326",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.001824",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCO",
            "last_name": "NOZICKA",
            "middle_name": "ANTONIO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; 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.