Active NPI
James Nichols, LCSW
- Clinical Social Worker
- Austin, TX
National Provider Identifier
1639788516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 62233
- Practice address
- 12319 Willow Wild Dr
Austin, TX 78758-2725 - Phone
- (812) 829-1701
- NPI assigned
- Jul 27, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 62233 | TX | Primary |
Addresses
Primary practice location
12319 Willow Wild Dr
Austin, TX 78758-2725
Mailing address
12138 Trotwood Dr
Austin, TX 78753-6935
Phone (512) 576-6035
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 |
|---|---|---|---|
| 62233 | TX | MD | Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595808000000",
"number": "1639788516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12138 TROTWOOD DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787536935",
"telephone_number": "512-576-6035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12319 WILLOW WILD DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787582725",
"telephone_number": "812-829-1701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "JAMES",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-07-27",
"last_updated": "2020-07-27",
"certification_date": "2020-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "62233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.