Grayson G Nichols, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C006446 Issued in NC

Practice address

5505 Creedmoor Rd Ste 100
Raleigh, NC 27612-6333

Phone

(919) 852-5352

Fax

(919) 852-5323

NPI assigned

Jul 30, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1689805285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1630",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283701630",
            "telephone_number": "910-295-6007",
            "fax_number": "910-215-0179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 CREEDMOOR RD STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276126333",
            "telephone_number": "919-852-5352",
            "fax_number": "919-852-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "GRAYSON",
        "middle_name": "G",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "C006446",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melody Nicholas, MA, LCMHCA, NCC
• Roslyn Crews Nicholas, P.T.
• Austin Kennedy Nichols, MD
• Brian Nichols, LAT, ATC
• Chyanne Nichols
• Marilouise Elizabeth Nichols, M.S., CCC-SLP, BCS-S
• Mark Lovel Nichols, MD
• Charles Hathaway Nicholson, MD
• Jasmin Nicholson
• Laura Lee Nicholson, OTR L

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.