Nicole Elizabeth Summers, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2002379 Issued in OH

Practice address

700 Brooksedge Blvd
Westerville, OH 43081-3394

Phone

(614) 882-9338

NPI assigned

May 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1831688670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 BROOKSEDGE BLVD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430813394",
            "telephone_number": "614-882-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 BROOKSEDGE BLVD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430813394",
            "telephone_number": "614-882-9338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "S.1700504",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2002379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Conor Sullivan
• Edward Mark Sullivan, MSW, LISW-S
• Jenna Sullivan
• Melissa Sullivan, RD
• Iris Leyretana Sumatra, MA
• Summerville at Outlook Manor, LLC
• Morgan Rashelle Sumner, OTR
• Rachel Sunday, PHARMD
• Sustainers Healthcare LLC
• Kyle Richard Sutton, MS, AT

• Clinical Social Worker in Westerville, OH
• Providers in Westerville, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.