Adam L Nickell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW- 36181 Issued in ID

Practice address

3270 E 17TH St # 131
Ammon, ID 83406-6758

Phone

(208) 534-6568

NPI assigned

Aug 5, 2014

Last updated

Sep 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pearl Health ClinicGroup PAC ID 0840356077, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Pearl Health Clinic

  • Mental Health Counselor
  • Ammon, ID
  • NPI 1447426465
  Medicare reassignment Care Compare group NPD
• Balance and Renewal PLLC

  • Clinical Social Worker
  • Ammon, ID
  • NPI 1790645638
  NPD Authorized official

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1497164347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 E 17TH ST # 131",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066758",
            "telephone_number": "208-534-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 E 17TH ST # 131",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066758",
            "telephone_number": "208-534-6568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2705 E 17th St",
            "address_purpose": "LOCATION",
            "city": "Ammon",
            "state": "ID",
            "postal_code": "834066669",
            "country_code": "US",
            "telephone_number": "208-346-7500",
            "fax_number": "208-346-7501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKELL",
        "first_name": "ADAM",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-05",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "14206814-3501",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCSW-36181",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW- 36181",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "14206814-3501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kevin Nelson
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• Richard A New, M.D.
• Jessica Nickerson, LCSW
• Daniel Glenn Nielson, OD
• Michelle Norman, NP
• Devin Taylor Norton
• Alannah Nunez

• Clinical Social Worker in Ammon, ID
• Providers in Ammon, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.