Nicole C Malcolm, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089888 Issued in NY

Practice address

40 Lantern Rd
Hicksville, NY 11801-6208

Phone

(516) 477-3667

NPI assigned

Oct 23, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Nicole Goldstein Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Seafield Center

  • Community/Behavioral Health Agency
  • Amityville, NY
  • NPI 1194141887
  NPD (past)

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1770836173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 LANTERN RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118016208",
            "telephone_number": "516-477-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 LANTERN RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118016208",
            "telephone_number": "516-477-3667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37 John St",
            "address_purpose": "LOCATION",
            "city": "Amityville",
            "state": "NY",
            "postal_code": "117012930",
            "country_code": "US",
            "telephone_number": "631-424-2900",
            "fax_number": "631-598-5716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALCOLM",
        "first_name": "NICOLE",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-23",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087724",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GOLDSTEIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marjolene Mahautiere
• Greg James Mahoney, LCSW
• James Maisel, M.D.
• Mahmuda Majahar, CM
• Calliope Makris, LMHC, LMSW
• Christina Maley
• Sajid Malik, MD
• Ryan Malle
• Jessica Mallozzi
• Dawnmarie Maloney, LMSW

• Clinical Social Worker in Hicksville, NY
• Providers in Hicksville, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; 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.