Active NPI
Linda Nicholson, LCSW
- Clinical Social Worker
- Fredericksburg, VA
National Provider Identifier
1720338031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904008025
- 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, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0904008025 | VA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mosaic Child & Family Counseling, PLLC | Clinical | Current | 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.
-
- Clinical Social Worker
- Fredericksburg, VA
- NPI 1013348481
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.