Active NPI
Justine Nicole Nicholas
- Clinical Social Worker
- Summersville, WV
National Provider Identifier
1558068676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- BP00946467
- Practice address
- 131 Wellness Dr
Summersville, WV 26651-5402 - Phone
- (888) 736-3229
- Fax
- (304) 872-5415
- NPI assigned
- Feb 9, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | BP00946467 | WV | Primary |
Addresses
Primary practice location
131 Wellness Dr
Summersville, WV 26651-5402
Mailing address
131 Wellness Dr
Summersville, WV 26651-5402
Phone (888) 736-3229
Other names 1
- Justine Nicole Nicholas
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
| License | State | Type | Specialty |
|---|---|---|---|
| BP00946467 | WV | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seneca Health Services Inc | Past | Accepting new patients | |
| Seneca Health Services, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Maxwelton, WV
- NPI 1245441609
-
- Family Medicine Physician
- Maxwelton, WV
- NPI 1235838954
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760486400000",
"number": "1558068676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 WELLNESS DR",
"city": "SUMMERSVILLE",
"state": "WV",
"postal_code": "266515402",
"telephone_number": "888-736-3229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 WELLNESS DR",
"city": "SUMMERSVILLE",
"state": "WV",
"postal_code": "266515402",
"telephone_number": "888-736-3229",
"fax_number": "304-872-5415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLAS",
"first_name": "JUSTINE",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-09",
"last_updated": "2025-10-15",
"certification_date": "2025-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WV",
"license": "BP00946467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JUSTINE",
"last_name": "NICHOLAS",
"middle_name": "NICOLE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Summersville, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.