Active NPI
Nicolle Wicker
- Clinical Social Worker
- Henderson, NV
National Provider Identifier
1871273474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 9364
- Practice address
- 2291 Smokey Sky Dr
Henderson, NV 89052-5823 - Phone
- (314) 398-4317
- NPI assigned
- Jul 19, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2004007600 | MO | |
| Clinical Social Worker | 1041C0700X | W60218770 | WA | |
| Clinical Social Worker | 1041C0700X | LCSW111258 | CA | |
| Clinical Social Worker | 1041C0700X | 9364 | NV | Primary |
Addresses
Primary practice location
2291 Smokey Sky Dr
Henderson, NV 89052-5823
Mailing address
2291 Smokey Sky Dr
Henderson, NV 89052-5823
Phone (314) 398-4317
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW111258 | CA | MD | Clinical Social Worker |
| 2004007600 | MO | MD | Clinical Social Worker |
| 9364 | NV | MD | Clinical Social Worker |
| W60218770 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689724800000",
"number": "1871273474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2291 SMOKEY SKY DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890525823",
"telephone_number": "314-398-4317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2291 SMOKEY SKY DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890525823",
"telephone_number": "314-398-4317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICKER",
"first_name": "NICOLLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-19",
"last_updated": "2023-07-19",
"certification_date": "2023-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2004007600",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "W60218770",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW111258",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NV",
"license": "9364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.