Marissa Nichols, MSW, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801108793 Issued in MI

Practice address

15350 N Commerce Dr Ste 204
Dearborn, MI 48120-1234

Phone

(313) 203-2077

NPI assigned

Feb 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rizzo Nichols Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1740874163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31521 NELSON DR",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480881865",
            "telephone_number": "586-899-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15350 N COMMERCE DR STE 204",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201234",
            "telephone_number": "313-203-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "MARISSA",
        "credential": "MSW, LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801108793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RIZZO",
            "last_name": "NICHOLS",
            "credential": "MSW, LLMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brandon T Nguyen, MD
• Michael Nguyen, DMD
• Demarco D Nicholas-Johnson
• Fiona Cathrine Nicholas
• Ashley Nichols, DO
• Gabrielle Nickerson
• Norma Lee Nicola, CRNA
• Nicole Sobh Therapy LLC
• Nidal Hammoud DDS. PLLC
• Rylie Nicole Niece

• Clinical Social Worker in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.