Individual provider Active NPI

Christine E Nicolosi, LCSW

  • Clinical Social Worker
  • Lexington, KY
National Provider Identifier
1689807406
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
257815 Issued in KY
Practice address
1055 Dove Run Rd Ste 215
Lexington, KY 40502-3536
Phone
(502) 680-1932
NPI assigned
Aug 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 257815 KY Primary
School Social Worker 1041S0200X

Addresses

Primary practice location

1055 Dove Run Rd Ste 215
Lexington, KY 40502-3536

Mailing address

269 Abbey Rd
Versailles, KY 40383-8063
Phone (502) 680-1932

Other identifiers 1

IdentifierTypeStateIssuer
7100888890MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20230811003275 KY Practitioner - Clinical Social Worker 4486016102 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1055 Dove Run Rd
Suite 215
Lexington, KY 40502-3536
Phone (502) 680-1932

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
257815KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
PPL Therapeutic Services PLLC Clinical CurrentSince Jul 25, 2023 Accepting new patients

Locations

100 Carmel Manor Dr
Fort Thomas, KY 41075
Phone (859) 781-5111

4200 Lawrenceburg Rd
Frankfort, KY 40601
Phone (502) 219-7762

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": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1689807406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 ABBEY RD",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403838063",
            "telephone_number": "502-680-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 DOVE RUN RD STE 215",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405023536",
            "telephone_number": "502-680-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLOSI",
        "first_name": "CHRISTINE",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "257815",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100888890",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.