Teresa L Dominique Nicholson, LLMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801106528 Issued in MI

Practice address

500 Hancock St
Saginaw, MI 48602-4224

Phone

(989) 797-3400

Fax

(989) 799-0206

NPI assigned

Mar 19, 2020

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 names 1

• Teresa L Dominique Williams Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Saginaw County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Saginaw, MI
  • NPI 1689778953
  Medicare reassignment NPD
• Therapy Today Counseling and Consulting, LLC

  • Clinical Social Worker
  • East Lansing, MI
  • NPI 1629322003
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1881220051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HANCOCK ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024224",
            "telephone_number": "989-797-3400",
            "fax_number": "989-799-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HANCOCK ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024224",
            "telephone_number": "989-797-3400",
            "fax_number": "989-799-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "TERESA",
        "middle_name": "L DOMINIQUE",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801106528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://sccmha.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 Hancock St",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486024224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "WILLIAMS",
            "middle_name": "L DOMINIQUE",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alethea Nichols-Taylor
• Ana Nichols
• Angela Lynn Nichols
• Lindsey Nichols, MD
• Tana Nichols
• Amber Lori Nickel
• Jordan Leigh Nickel
• Jessica Lynn Nickell
• Thomasine Nickleberry
• Nicole Throop Counseling and Consulting PLLC

• Social Worker in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.