Nicole Iacovoni, LCSW, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW017138 Issued in PA

Practice address

214 Center St
Bloomsburg, PA 17815-1752

Phone

(570) 336-9921

NPI assigned

Jan 19, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Willow Tree Wellness and Counseling LLCGroup PAC ID 6103275508, 3 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 and National Provider Directory roles.

• Willow Tree Wellness & Counseling, LLC

  • Clinical Social Worker
  • Bloomsburg, PA
  • NPI 1649521584
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1578834784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 CENTER ST",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178151752",
            "telephone_number": "570-336-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 CENTER ST",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178151752",
            "telephone_number": "570-336-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACOVONI",
        "first_name": "NICOLE",
        "credential": "LCSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Humphrey
• Jennifer A. Hunsinger, MS, NCC, LPC, RPT
• Nathan Robert Hunter, RPH
• Husky Research Corporation Inc
• Jane Kathleen Hyde, CST CSA
• Nelson Anthony Iannuzzi, CRNP
• Fieza Ibrahim
• Incare LLC
• Innerclarity LLC
• Sehar Irfan

• Clinical Social Worker in Bloomsburg, PA
• Providers in Bloomsburg, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.