Individual provider Active NPI

Linda Nicholson, LCSW

  • Clinical Social Worker
  • Fredericksburg, VA
National Provider Identifier
1720338031
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008025 Issued in VA
Practice address
615 Emancipation Hwy Ste 202
Fredericksburg, VA 22401-8407
Phone
(540) 373-2111
Fax
(540) 373-2227
NPI assigned
Sep 13, 2012
Last updated
Feb 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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 0904008025 VA Primary

Addresses

Primary practice location

615 Emancipation Hwy Ste 202
Fredericksburg, VA 22401-8407

Mailing address

615 Emancipation Hwy Ste 202
Fredericksburg, VA 22401-8407
Phone (540) 373-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904008025VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Child & Family Counseling, PLLC Clinical CurrentSince Dec 1, 2019 Accepting new patients

Locations

615 Emancipation Hwy
Ste 202
Fredericksburg, VA 22401
Phone (540) 373-2111

403 William St
Ste B
Fredericksburg, VA 22401
Phone (804) 366-0641

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1720338031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 EMANCIPATION HWY STE 202",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224018407",
            "telephone_number": "540-373-2111",
            "fax_number": "540-373-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 EMANCIPATION HWY STE 202",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224018407",
            "telephone_number": "540-373-2111",
            "fax_number": "540-373-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "LINDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.