Individual provider Active NPI

Nicole J Pimble, LCSW

  • Clinical Social Worker
  • Oreland, PA
National Provider Identifier
1760425557
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW014320 Issued in PA
Practice address
103 Montgomery Ave
Oreland, PA 19075-1810
Phone
(215) 559-9011
NPI assigned
Jun 13, 2006
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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 CW014320 PA Primary

Addresses

Primary practice location

103 Montgomery Ave
Oreland, PA 19075-1810

Mailing address

103 Montgomery Ave
Oreland, PA 19075-1810
Phone (215) 559-9011

Other identifiers 2

IdentifierTypeStateIssuer
2321214000OtherPAINDEPENDENCE BC
7749232OtherPAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20040914000418 PA Practitioner - Clinical Social Worker 1355318890 Reassigns benefits to 1 organization
Practice locations: Horsham, PA; Southampton, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3959 Welsh Rd
Suite 159
Willow Grove, PA 19090-2900
Phone (215) 559-9011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW014320PAMDClinical Social Worker
11585MDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Deborah Meyrowitz Weiss LLC PastSince Nov 20, 2015 Accepting new patients
Jewish Family & Childrens Serv Clinical PastSince May 10, 2023 Accepting new patients
Catholic Social Services Clinical Past Accepting new patients
Delaware Guidance Services for Children & Youth, Inc. Past Accepting new patients

Organizations & group practices 5

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1760425557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MONTGOMERY AVE",
            "city": "ORELAND",
            "state": "PA",
            "postal_code": "190751810",
            "telephone_number": "215-559-9011",
            "fax_number": "302-652-8297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MONTGOMERY AVE",
            "city": "ORELAND",
            "state": "PA",
            "postal_code": "190751810",
            "telephone_number": "215-559-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIMBLE",
        "first_name": "NICOLE",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BC",
            "identifier": "2321214000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7749232",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oreland, PA

Sources for this page

Verify at the official NPI Registry.