Vivian Elaine Nickless, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

R026808 Issued in NY

Practice address

109 North Main St
North Syracuse, NY 13212

Phone

(315) 452-6808

Fax

(315) 452-6810

NPI assigned

Oct 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Clinical Social Worker

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bright Path Center, Inc.

  • Social Worker
  • North Syracuse, NY
  • NPI 1316046113
  NPD (past)
• Delconte Counseling LCSW PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • N Syracuse, NY
  • NPI 1427810787

  Social Worker

  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891876629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 NORTH MAIN ST",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "13212",
            "telephone_number": "315-452-6808",
            "fax_number": "315-452-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 NORTH MAIN ST",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "13212",
            "telephone_number": "315-452-6808",
            "fax_number": "315-452-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKLESS",
        "first_name": "VIVIAN",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "R026808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New York Anesthesiology Medical Specialties PC
• Jaimie W Newman, PA
• Colleen Ney, M.T.
• Stephanie Luu Nguyen, L.AC.
• Alison Nicholson, LMT
• Raisa Nishat, PHARMD
• Andrea Noffey, PA
• Morgan Noffey, PHARMD
• Birx Frances Nolan, MD
• North Area Meals on Wheels

• All providers in North Syracuse, NY
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.