Individual provider Active NPI

Nicole Alexandra Nina

  • Clinical Social Worker
  • Aurora, CO
National Provider Identifier
1558037267
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09927774 Issued in CO
Practice address
22477 E Dorado PL
Aurora, CO 80015-6507
Phone
(720) 725-8224
NPI assigned
Aug 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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 LSW.0009922771 CO
Clinical Social Worker 1041C0700X CSW.09927774 CO Primary

Addresses

Primary practice location

22477 E Dorado PL
Aurora, CO 80015-6507

Mailing address

PO Box 461554
Aurora, CO 80046-1554
Phone (303) 900-5601

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
LSW.0009922771COMDSocial Worker
CSW.09927774COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1629590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1558037267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 461554",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800461554",
            "telephone_number": "303-900-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22477 E DORADO PL",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800156507",
            "telephone_number": "720-725-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NINA",
        "first_name": "NICOLE",
        "middle_name": "ALEXANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-22",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "LSW.0009922771",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09927774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.