Individual provider Active NPI

Lacey K Nicholson

  • Clinical Social Worker
  • Ashland, KY
National Provider Identifier
1487293544
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
258889 Issued in KY
Practice address
1000 Ashland Dr Ste 301
Ashland, KY 41101-7097
Phone
(606) 408-3143
Fax
(606) 325-8486
NPI assigned
Jan 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X BP00945412 WV
Clinical Social Worker 1041C0700X 258889 KY Primary

Addresses

Primary practice location

1000 Ashland Dr Ste 301
Ashland, KY 41101-7097

Mailing address

PO Box 1595
Ashland, KY 41105-1595
Phone (606) 408-6200

Other practice location 1

3375 US Route 60
Huntington, WV 25705-2837
Phone (304) 525-7851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20240605000879 KY Practitioner - Clinical Social Worker 6204378359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashland Hospital CorporationGroup PAC ID 7719882521, 169 clinicians

Practice addresses (Care Compare)

1061 Kenwood Dr
Russell, KY 41169-1527
Phone (606) 408-3143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BP00945412WVMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ashland Hospital Corporation Clinical CurrentSince May 13, 2024 Accepting new patients
Ashland Hospital Corporation Current Accepting new patients
Ashland Hospital Corporation CurrentSince May 13, 2024 Accepting new patients

Locations

1000 Ashland Dr
Ste 301
Ashland, KY 41101
Phone (606) 326-0322

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

12100 Princeland Spur
Ashland, KY 41102
Phone (606) 928-2963

1061 Kenwood Dr
Russell, KY 41169
Phone (606) 326-1675

Organizations & group practices 3

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": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1487293544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1595",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411051595",
            "telephone_number": "606-408-6200",
            "fax_number": "606-460-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ASHLAND DR STE 301",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017097",
            "telephone_number": "606-408-3143",
            "fax_number": "606-325-8486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3375 US Route 60",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257052837",
            "country_code": "US",
            "telephone_number": "304-525-7851",
            "fax_number": "304-525-1073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "LACEY",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-06",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "BP00945412",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "258889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.