Elizabeth Nickerson, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

C-06307 Issued in NM

Practice address

2301 Yale Blvd SE
Albuquerque, NM 87106-4228

Phone

(505) 272-1379

NPI assigned

Jun 26, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Elizabeth Ellis-Cruz Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: elizabeth.nickerson.1@30520.direct.athenahealth.com

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1831619329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 PURPLE FRINGE RD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871216382",
            "telephone_number": "219-308-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 YALE BLVD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064228",
            "telephone_number": "505-272-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008210A",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "C-06307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "ELLIS-CRUZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Audra Jayne Nickel
• Ursula Maria Luise Nickel, DOM
• Amanda Sabria Nickelberry
• Samuel Aaron Nickell, MD
• Angela Nicole Nickens
• Patricia F Nicknish
• Ronald Nicks Jr., PHARMD
• David Niclas, LMHC
• Whitnee Nicole Nicley, MS
• Jessica Taylor Nico, M.A., CCC-SLP, TSSLD

• Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.