Individual provider Active NPI

Nicoda Ricketts, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1689065948
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
109186 Issued in TX
Practice address
3705 Medical Pkwy
Austin, TX 78705-1019
Phone
(718) 299-3045
NPI assigned
Feb 9, 2015
Last updated
Jul 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 094247-1 NY
Clinical Social Worker 1041C0700X 109186 TX Primary

Addresses

Primary practice location

3705 Medical Pkwy
Austin, TX 78705-1019

Mailing address

3705 Medical Pkwy
Austin, TX 78705-1019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250814001725 TX Practitioner - Clinical Social Worker 5698274041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

3705 Medical Pkwy
Suite 410
Austin, TX 78705-1023
Phone (888) 374-5066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
094247-1NYMDSocial Worker
109186TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center LLC, CurrentSince Jul 1, 2025 Accepting new patients
Family Care Center, LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

3705 Medical Pkwy
Austin, TX 78705
Phone (512) 368-5294

3705 Medical Pkwy
Ste 410
Austin, TX 78705
Phone (512) 320-5779

551 S Interstate 35
Ste 200
Round Rock, TX 78664
Phone (512) 241-7314

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1689065948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 MEDICAL PKWY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 MEDICAL PKWY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051019",
            "telephone_number": "718-299-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "NICODA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-09",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "094247-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "109186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.