Laurianne Nichols, LCSW
Individual provider Active NPI Clinical Social Worker · Plover, WI
NPI 1740338995 · NPPES record last updated Mar 14, 2008
Key facts
- NPI
- 1740338995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2738-123 (WI)
- Practice address
- 2450 Vineyard Dr
Plover, WI 54467-3973 - Phone
- (715) 342-0290
- Fax
- (715) 342-0291
- NPI assigned
- Jan 6, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2738-123 | WI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2738-123 | WI | Yes |
Addresses
Primary practice location
2450 Vineyard Dr
Plover, WI 54467-3973
Mailing address
W5807 Glen Ave
Endeavor, WI 53930-9552
Phone (608) 587-2556
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39267300 | Medicaid | WI |
Other providers in Plover, WI
- Ministry Home Care, LLC.
- Matthew D Moen
- Chris D Moore
- More Than Words LLC
- Colin S Munn
- North Haven Inc.
- Roxanne Nowak
- Anna K Nummelin
- Angela M Okon
- Oswald Counseling Associates, Inc.
All providers in Plover, WI · Clinical Social Worker in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2008. 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.