Individual provider Active NPI

Amy Michelle Nichols, LICSW

  • Clinical Social Worker
  • Lowell, MA
National Provider Identifier
1871765560
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
122683 Issued in MA
Practice address
21 George St FL 1
Lowell, MA 01852-2228
Phone
(978) 453-5736
NPI assigned
Apr 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34005123A IN
Clinical Social Worker 1041C0700X 122683 MA Primary

Addresses

Primary practice location

21 George St FL 1
Lowell, MA 01852-2228

Mailing address

21 George St FL 1
Lowell, MA 01852-2228
Phone (978) 453-5736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20230731001679 MA Practitioner - Clinical Social Worker 0244409431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hri Clinics, Inc.Group PAC ID 8022088483, 104 clinicians

Practice addresses (Care Compare)

21 George St
Lowell, MA 01852-2228
Phone (978) 453-5736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34005123AINMDClinical Social Worker
122683MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hri Clinics, Inc. CurrentSince Jul 3, 2023 Accepting new patients
Hri Clinics Inc CurrentSince Jul 3, 2023 Accepting new patients

Locations

14 Fordham Rd
Boston, MA 02134
Phone (617) 783-9676

21 George St
Fl 1
Lowell, MA 01852
Phone (978) 453-5736

21 George St
Lowell, MA 01852
Phone (978) 453-5736

Organizations & group practices 2

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": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1871765560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GEORGE ST FL 1",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018522228",
            "telephone_number": "978-453-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GEORGE ST FL 1",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018522228",
            "telephone_number": "978-453-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "AMY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005123A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "122683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.