Individual provider Active NPI

Nicole Williams

  • Clinical Social Worker
  • Ithaca, NY
National Provider Identifier
1831729359
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
100053-01 Issued in NY
Practice address
201 E Green St
Ithaca, NY 14850-5635
Phone
(607) 274-6208
NPI assigned
Jan 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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 100053-01 NY Primary

Addresses

Primary practice location

201 E Green St
Ithaca, NY 14850-5635

Mailing address

201 E Green St
Ithaca, NY 14850-5635
Phone (607) 274-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250610001253 NY Practitioner - Clinical Social Worker 1456861301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tompkins CountyGroup PAC ID 0143210443, 19 clinicians

Practice addresses (Care Compare)

201 E Green St
Ithaca, NY 14850-5635
Phone (607) 274-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100053-01NYMDClinical Social Worker
111572NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Tompkins County CurrentSince Apr 29, 2025 Accepting new patients

Locations

201 E Green St
Ithaca, NY 14850
Phone (607) 274-6200

Organizations & group practices 1

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": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1831729359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E GREEN ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505635",
            "telephone_number": "607-274-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E GREEN ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505635",
            "telephone_number": "607-274-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "100053-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.