Donna Jean Nickelberry, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SWI.LW.00009403 Issued in WA

Practice address

221 Wells Ave S
Renton, WA 98057-2161

Phone

(253) 833-7444

Fax

(253) 661-8631

NPI assigned

Feb 24, 2016

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 identifiers 1

Other names 1

• Miss Donna Jean Green Former name

Medicare fee-for-service enrollment

Enrolled in WA

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.

• Valley Cities Counseling and Consultation

  • Community/Behavioral Health Agency
  • Kent, WA
  • NPI 1972668853
  Medicare reassignment NPD

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1902266612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W GOWE ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980325892",
            "telephone_number": "253-833-7444",
            "fax_number": "253-661-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 WELLS AVE S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572161",
            "telephone_number": "253-833-7444",
            "fax_number": "253-661-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELBERRY",
        "first_name": "DONNA",
        "middle_name": "JEAN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-24",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SWI.LW.00009403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2119380",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "GREEN",
            "middle_name": "JEAN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danika K Nice, PT
• Nicholas Raklios, DDS, PLLC (Pristera Orthodontics)
• Stephanie Nichols
• Taylor Nichols, DPT
• Nick Erber-Lapierre PLLC
• Sheena Jean Gallardo Nicolay
• Brant Niedenthal, PHARM.D.
• Paul Niemi, ARNP
• Sandeep Kaur Nijjar
• Karen Nilson, MD

• Clinical Social Worker in Renton, WA
• Providers in Renton, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; 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.