Individual provider Active NPI

Lindsay Nicole Nickens

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1699173617
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
093170-1 Issued in NY
Practice address
53 E 66TH St Ste a
New York, NY 10065-6148
Phone
(212) 328-9182
NPI assigned
Dec 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 093170-1 NY Primary

Addresses

Primary practice location

53 E 66TH St Ste a
New York, NY 10065-6148

Mailing address

53 E 66TH St Ste a
New York, NY 10065-6148
Phone (212) 328-9182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 26, 2023 through Dec 26, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
086865NYMDClinical Social Worker
093170-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1699173617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 E 66TH ST STE A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656148",
            "telephone_number": "212-328-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 E 66TH ST STE A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656148",
            "telephone_number": "212-328-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKENS",
        "first_name": "LINDSAY",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-08",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093170-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.