Jill Nuckolls, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

5350 S Western Ave
Suite 555
Oklahoma City, OK 73109-4520

Phone

(405) 631-4567

Fax

(405) 996-2113

NPI assigned

Aug 27, 2008

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

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.

• Shadow Mountain Behavioral Health System, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oklahoma City, OK
  • NPI 1316056534
  NPD (past)

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1487801882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6262 S SHERIDAN RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334055",
            "telephone_number": "918-492-8200",
            "fax_number": "918-493-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 S WESTERN AVE",
            "address_2": "SUITE 555",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731094520",
            "telephone_number": "405-631-4567",
            "fax_number": "405-996-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUCKOLLS",
        "first_name": "JILL",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nu-Sound Hearing Labs, Inc
• Nubia Fiesel, LPC, PLLC
• Jonathan Nubine, B.S.
• Laura Diedra Nubine
• Flavour Nubonyin, PHARMACIST
• Summer Ann Nuckolls
• Nueva Esperanza LLC
• Nugenerex Pok1 LLC
• Esther M Nuhu
• Kehdinga Nukuna

• Clinical Social Worker in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.