Individual provider Active NPI

Nicole Andrea Holcomb, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1669736062
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-09079 Issued in NM
Practice address
6804 La Rocca Rd NW
Albuquerque, NM 87114-3647
Phone
(505) 358-5954
NPI assigned
Jun 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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 C-09079 NM Primary

Addresses

Primary practice location

6804 La Rocca Rd NW
Albuquerque, NM 87114-3647

Mailing address

6804 La Rocca Rd NW
Albuquerque, NM 87114-3647
Phone (505) 358-5954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20160316001538 NM Practitioner - Clinical Social Worker 4981900982 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Small Steps Child Counseling, LLC CurrentSince Feb 9, 2016 Accepting new patients
The Community Lighthouse Past Accepting new patients

Locations

707 Broadway Blvd NE
Ste 103
Albuquerque, NM 87102
Phone (505) 766-9361

1101 Medical Arts Ave NE
Bldg 3
Albuquerque, NM 87102
Phone (505) 842-5300

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.

NPI Registry JSON

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1669736062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6804 LA ROCCA RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871143647",
            "telephone_number": "505-358-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6804 LA ROCCA RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871143647",
            "telephone_number": "505-358-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLCOMB",
        "first_name": "NICOLE",
        "middle_name": "ANDREA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-09079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.