Nicole Farrell, LCSW
Individual provider Active NPI Clinical Social Worker · San Fernando, CA
NPI 1780194274 · NPPES record last updated Feb 28, 2025
Key facts
- NPI
- 1780194274
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 27756 (CA)
- Practice address
- 11565 Laurel Canyon Blvd
San Fernando, CA 91340-4168 - Phone
- (818) 361-5030
- NPI assigned
- Oct 10, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27756 | CA | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SCV Counseling Marriage and Family Therapy Center Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 27756 | CA | Yes |
Addresses
Primary practice location
11565 Laurel Canyon Blvd
San Fernando, CA 91340-4168
Mailing address
18901 Knapp St
Northridge, CA 91324-2840
Phone (818) 693-0877
Other providers in San Fernando, CA
- Nicole Fakhimi
- Juan Pablo Falabella
- Tania Marie Fallert
- Joud Fansa
- Farid Yasharpour MD a Medical Corp.
- Kaycie Faulkner
- Jaquelin Paola Fierros
- Andrea Figueroa
- Firstline Health, Inc.
- Nancy Elizabeth Fitts
All providers in San Fernando, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2025. 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.