Judy Nichols, LCSW
Individual provider Active NPI Clinical Social Worker · Surf City, NJ
NPI 1710337142 · NPPES record last updated Jun 16, 2016
Key facts
- NPI
- 1710337142
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 44SC05661300 (NJ)
- Practice address
- 2012 Long Beach Blvd
Surf City, NJ 08008-5551 - Phone
- (609) 276-1660
- NPI assigned
- Jun 16, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC05661300 | NJ | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC05661300 | NJ | Yes |
Addresses
Primary practice location
2012 Long Beach Blvd
Surf City, NJ 08008-5551
Mailing address
2012 Long Beach Blvd
Surf City, NJ 08008-5551
Phone (609) 276-1660
Other providers in Surf City, NJ
- Edward Gerard Barbieri III
- Jeanette Glover
- Dorsey Grieve
- Richard Charles Hunt
- Charles S Krueger
- Surf City Pharmacy Inc
- Elizabeth Taylor
All providers in Surf City, NJ · Clinical Social Worker in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.