Nicolette Re, LCSW, ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-12205 Issued in AZ

Practice address

20121 N 76TH St Unit 2057
Scottsdale, AZ 85255-3872

Phone

(480) 677-1198

NPI assigned

Oct 21, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Suzanne Terra Nicolette Former name

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": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1841526118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20121 N 76TH ST UNIT 2057",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852553872",
            "telephone_number": "480-677-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20121 N 76TH ST UNIT 2057",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852553872",
            "telephone_number": "480-677-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RE",
        "first_name": "NICOLETTE",
        "name_prefix": "Ms.",
        "credential": "LCSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-12205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL SOCIAL WORK LICENSE",
            "identifier": "LCSW-12205",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "NICOLETTE",
            "middle_name": "TERRA",
            "prefix": "MS.",
            "credential": "LCSW, ACSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mirla G. Raz, M.ED., CCC-SLP
• Arash Razi, MD
• Diego Esau Razura, MD
• Soledad Razuri, DDS
• Meagan Re
• Lisa Nicole Rea
• Ready Set Play Learning Services, LLC
• Real Food Nutrition Therapy LLC
• Lisa Anne Reaume, CRNA
• Kendall Anne Reaves

• Clinical Social Worker in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; 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.