Stefani Kristine Nichols, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L4903 Issued in OR

Practice address

3180 Center St NE
Salem, OR 97301-4532

Phone

(503) 588-5351

NPI assigned

Nov 19, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Marion County

  • Methadone Clinic
  • Salem, OR
  • NPI 1386706919
  NPD (past)
• Marion County

  • Adult Mental Health Clinic/Center
  • Salem, OR
  • NPI 1528147782
  NPD (past)

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1801077854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 5TH ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011243",
            "telephone_number": "503-910-3519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 CENTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014532",
            "telephone_number": "503-588-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "STEFANI",
        "middle_name": "KRISTINE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Stevens Nicholl, LMT
• Delia Ione Nichols-Ferguson
• Erin Nichols
• Katelyn Nichols
• Nicole Marie Nichols
• Tori Nichols
• Diana Nicholson-Nelson, LCSW, MSW
• Gilbert Earl Nicholson-Nelson, M.S.W., L.C.S.W.
• Jacob Nicholson, N.P.
• Jennifer M Nickell, FNP

• Clinical Social Worker in Salem, OR
• Providers in Salem, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; 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.