Individual provider Active NPI

Katy L Nicholls, LCSW

  • Clinical Social Worker
  • Aurora, CO
National Provider Identifier
1811184682
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09924800 Issued in CO
Practice address
791 Chambers Rd
Aurora, CO 80011-7112
Phone
(303) 617-2300
NPI assigned
Sep 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 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 CSW.09924800 CO Primary

Addresses

Primary practice location

791 Chambers Rd
Aurora, CO 80011-7112

Mailing address

1290 Chambers Rd
Aurora, CO 80011-7117
Phone (303) 617-2300

Other identifiers 1

IdentifierTypeStateIssuer
000070346OtherMTBLUE CROSS-SHIELD OF MONT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09924800COMDClinical Social Worker
805MTMDMedical Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Mental Health Clinical PastSince Apr 22, 2013 Accepting new patients
Merrit Psychiatry PLLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1811184682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 CHAMBERS RD",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800117117",
            "telephone_number": "303-617-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 CHAMBERS RD",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800117112",
            "telephone_number": "303-617-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLLS",
        "first_name": "KATY",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09924800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-SHIELD OF MONT",
            "identifier": "000070346",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; 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.