Janice Denise Nichols, MPA, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

93399 Issued in CA

Practice address

11701 Palm Lake Dr Apt 1411
Jacksonville, FL 32218-0918

Phone

(904) 598-4519

NPI assigned

Aug 19, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, CA, TX, SC, WA5 enrollments

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 5

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Live Life Now Health Group of California PCGroup PAC ID 2769898378, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts, Master of Arts

State licenses

Practice roles

Locations

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.

• Live Life Now Health Group of California PC

  dba Monument Telehealth Group

  • Addiction Medicine (Family Medicine) Physician
  • Commerce, CA
  • NPI 1194332510
  Medicare reassignment Care Compare group NPD
• Ah Addiction Care of California PC

  dba Anonymous Health

  • Addiction Medicine (Family Medicine) Physician
  • Sacramento, CA
  • NPI 1144055302
  Medicare reassignment NPD
• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1801355482

  TX

  Medicare reassignment NPD
• Live Life Now Health Group PA

  dba Monument Telehealth Group

  • Addiction Medicine (Family Medicine) Physician
  • Yonkers, NY
  • NPI 1770111429

  SC, TX, WA

  Medicare reassignment NPD
• Sud Specialty Group - Ca

  dba Rula Health

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Clinical

  Medicare reassignment NPD
• Cyti Health PC

  dba Cyti Psychological

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1679172290
  Medicare reassignment
• Myezmed

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1982441341

  FL

  Medicare reassignment
• Ah Addiction Care PC

  dba Anonymous Health

  • Addiction Medicine (Family Medicine) Physician
  • Redwood City, CA
  • NPI 1295516128
  NPD (past)

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1689980393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3887 EAGLE ROCK RD",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320689129",
            "telephone_number": "904-476-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 PALM LAKE DR APT 1411",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322180918",
            "telephone_number": "904-598-4519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JANICE",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "MPA, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-19",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "LISW9656",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "54866",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9933",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "93399",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "61116395",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jontaye Nicholas
• Cheri Leanne Nicholls, APRN
• Catherine Buckingham Nichols, APRN
• Daniel Nichols, MD
• Erin J Nichols, RD
• Naajzidah Nichols
• Romaine Charles Nichols Jr., M.D.
• Cherie Danielle Nicholson, APRN
• Cory Nicholson
• Courtney N Nicholson, PA-C

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.