NPIMap

Individual provider Active NPI

Nicolette Lee Hinkle, MSW, LCSW

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1871661918
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
82860 Issued in CA
Practice address
160 E Virginia St Ste 280
San Jose, CA 95112-5817
Phone
(408) 287-6200
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 82860 CA
Clinical Social Worker 1041C0700X 82860 CA Primary

Addresses

Primary practice location

160 E Virginia St Ste 280
San Jose, CA 95112-5817

Mailing address

PO Box 59057
San Jose, CA 95159-0057
Phone (650) 409-5255

Other practice location 1

1625 The Alameda Ste 201
San Jose, CA 95126-2223
Phone (650) 409-5255

Other names 1

  • Mrs. Nicolette Crystal Lee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181017001372 CA Practitioner - Clinical Social Worker 7618229717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gardner Family Health Network Inc 24 clinicians

Practice addresses (Care Compare)

160 E Virginia St
Suite 100
San Jose, CA 95112-5865
Phone (408) 918-2618

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
82860CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gardner Family Health Network, Inc. Current Accepting new patients
Gardner Family Health Network CurrentSince Mar 25, 2025 Accepting new patients
Gardner Family Health Network Inc CurrentSince Mar 25, 2025 Accepting new patients

Locations

160 E Virginia St
Ste 280
San Jose, CA 95112
Phone (408) 457-7100

160 E Virginia St
Ste 100
San Jose, CA 95112
Phone (408) 918-2618

Organizations & group practices 9

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1871661918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 59057",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951590057",
            "telephone_number": "650-409-5255",
            "fax_number": "650-409-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E VIRGINIA ST STE 280",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125817",
            "telephone_number": "408-287-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1625 The Alameda Ste 201",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951262223",
            "country_code": "US",
            "telephone_number": "650-409-5255",
            "fax_number": "650-409-5410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINKLE",
        "first_name": "NICOLETTE",
        "middle_name": "LEE",
        "name_prefix": "Miss",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "82860",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "82860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLETTE",
            "last_name": "LEE",
            "middle_name": "CRYSTAL",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.