Individual provider Active NPI

Nicole K. Nakagama, LCSW-C

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1568080190
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22803 Issued in MD
Practice address
604 Solarex CT Unit 201
Frederick, MD 21703-8655
Phone
(301) 663-8263
Fax
(301) 682-5326
NPI assigned
Jul 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 22803 MD Primary

Addresses

Primary practice location

604 Solarex CT Unit 201
Frederick, MD 21703-8655

Mailing address

604 Solarex CT Unit 201
Frederick, MD 21703-8655
Phone (301) 663-8263

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
22803MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1568080190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 SOLAREX CT UNIT 201",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038655",
            "telephone_number": "301-663-8263",
            "fax_number": "301-682-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 SOLAREX CT UNIT 201",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038655",
            "telephone_number": "301-663-8263",
            "fax_number": "301-682-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAGAMA",
        "first_name": "NICOLE",
        "middle_name": "K.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "22803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.