Shawn Marie Niccolls, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW 9197 Issued in FL

Practice address

8443 N Oak River Way
Hernando, FL 34442-2344

Phone

(352) 455-9710

Fax

(352) 341-2483

NPI assigned

Jul 20, 2006

Last updated

May 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Serenity Landing Therapy

  • Community/Behavioral Health Agency
  • Mount Dora, FL
  • NPI 1275048456
  NPD (past) Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715990400000",
    "number": "1720008071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8443 N OAK RIVER WAY",
            "city": "HERNANDO",
            "state": "FL",
            "postal_code": "344422344",
            "telephone_number": "352-455-9710",
            "fax_number": "352-341-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8443 N OAK RIVER WAY",
            "city": "HERNANDO",
            "state": "FL",
            "postal_code": "344422344",
            "telephone_number": "352-455-9710",
            "fax_number": "352-341-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICCOLLS",
        "first_name": "SHAWN",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 9197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Morales, MA
• John Mosley Jr.
• Liza A. Mozingo, MPA, PA-C
• Myeyedr. Optometry of Florida, LLC (MyEyeDr.)
• Anna Elizabeth Newlon
• Matthew Nixon, DC
• Bharat V Parikh, MD
• Won H Park, M.D.
• Shauna Lori Parrish, MS, CCC-SLP
• Parshwa LLC

• Clinical Social Worker in Hernando, FL
• Providers in Hernando, 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 May 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.