Individual provider Active NPI

Raylinn G. Nuckolls, LSCSW

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1881306595
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06977 Issued in KS
Practice address
2707 E 21St St N
Wichita, KS 67214-2249
Phone
(316) 691-0249
Fax
(866) 514-0974
NPI assigned
Dec 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 06977 KS Primary

Addresses

Primary practice location

2707 E 21St St N
Wichita, KS 67214-2249

Mailing address

2707 E 21St St N
Wichita, KS 67214-2249
Phone (316) 691-0249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20260211001038 KS Practitioner - Clinical Social Worker 0749769552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychiatric and Counseling Associates LLCGroup PAC ID 6507881422, 41 clinicians

Practice addresses (Care Compare)

1855 N Webb Rd
Wichita, KS 67206-3413
Phone (316) 636-2888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06977KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcore Clinic Inc CurrentSince Dec 20, 2025 Accepting new patients

Locations

2707 E 21st St N
Wichita, KS 67214
Phone (316) 691-0249

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": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1881306595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142249",
            "telephone_number": "316-691-0249",
            "fax_number": "866-514-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142249",
            "telephone_number": "316-691-0249",
            "fax_number": "866-514-0974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUCKOLLS",
        "first_name": "RAYLINN",
        "middle_name": "G.",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "06977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.