Individual provider Active NPI

Lawrence McNickles

  • Case Manager/Care Coordinator
  • Cincinnati, OH
National Provider Identifier
1689189334
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
3740 Glenway Ave
Cincinnati, OH 45205-1354
Phone
(513) 354-5200
NPI assigned
Dec 4, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

3740 Glenway Ave
Cincinnati, OH 45205-1354

Mailing address

3740 Glenway Ave
Cincinnati, OH 45205-1354

Other identifiers 1

IdentifierTypeStateIssuer
N-A-1OtherLICENSURE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180326002673 OH Practitioner - Clinical Social Worker 6204198583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1501 Madison Rd
Walnut Hills, OH 45206-1706
Phone (513) 354-7000

1501 Madison Rd
Cincinnati, OH 45206-1776

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Cincinnati Behavioral Health Services CurrentSince Feb 17, 2018 Accepting new patients
Greater Cincinnati Behavioral Health Services Current Accepting new patients
Greater Cincinnati Behavioral Health Services CurrentSince Feb 17, 2018 Accepting new patients
Inspire Counseling and Consulting CurrentSince Jul 12, 2020 Accepting new patients
Greater Cincinnati Behavioral Health Services Past Accepting new patients

Locations

8780 Colerain Ave
Cincinnati, OH 45251
Phone (513) 309-5280

1501 Madison Rd
Walnut Hills, OH 45206
Phone (513) 354-7000

1501 Madison Rd
Fl 2
Walnut Hills, OH 45206
Phone (513) 354-7079

Organizations & group practices 5

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": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1689189334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 GLENWAY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452051354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 GLENWAY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452051354",
            "telephone_number": "513-354-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNICKLES",
        "first_name": "LAWRENCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-04",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "N-A-1",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.