Individual provider Active NPI

Nichole Marie Laliberte, LCSW

  • Clinical Social Worker
  • Fort Collins, CO
National Provider Identifier
1528186202
Registry record updated Oct 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1042 Issued in CO
Practice address
420 S Howes St
Ste B-100
Fort Collins, CO 80521-2871
Phone
(303) 525-8331
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1042 CO Primary

Addresses

Primary practice location

420 S Howes St
Ste B-100
Fort Collins, CO 80521-2871

Mailing address

PO Box 1806
Fort Collins, CO 80522-1806
Phone (303) 525-8331

Other identifiers 1

IdentifierTypeStateIssuer
39909344MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20150106002018 CO Practitioner - Clinical Social Worker 0648490664 Reassigns benefits to 1 organization
Practice locations: Fort Collins, CO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

420 S Howes St
Suite B 100
Fort Collins, CO 80521-2871
Phone (303) 525-8331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1042COMDPhysician Assistant
736COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
A Peaceful Mind LLC Clinical CurrentSince Jan 1, 2021 Accepting new patients

Locations

420 S Howes St
Ste B100
Fort Collins, CO 80521
Phone (303) 525-8331

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601769600000",
    "number": "1528186202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1806",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805221806",
            "telephone_number": "303-525-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S HOWES ST",
            "address_2": "STE B-100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805212871",
            "telephone_number": "303-525-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALIBERTE",
        "first_name": "NICHOLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-10-04",
        "certification_date": "2020-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "1042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39909344",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.