Individual provider Active NPI

Nicole Marie Williams, LSW, MSW

  • Social Worker
  • Cleveland, OH
National Provider Identifier
1902519572
Registry record updated Sep 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.2512560 Issued in OH
Practice address
12200 Fairhill Rd
Cleveland, OH 44120-1058
Phone
(216) 218-8259
NPI assigned
Dec 28, 2022
Last updated
Sep 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.2512560 OH Primary

Addresses

Primary practice location

12200 Fairhill Rd
Cleveland, OH 44120-1058

Mailing address

12200 Fairhill Rd Ste E189
Cleveland, OH 44120-1069
Phone (216) 218-8259

Other practice location 1

7055 Engle Rd Bldg 6-601
Middleburg Heights, OH 44130-8491
Phone (216) 260-3363

Other identifiers 1

IdentifierTypeStateIssuer
2864093MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790467200000",
    "number": "1902519572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 FAIRHILL RD STE E189",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201069",
            "telephone_number": "216-218-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 FAIRHILL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201058",
            "telephone_number": "216-218-8259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7055 Engle Rd Bldg 6-601",
            "address_purpose": "LOCATION",
            "city": "Middleburg Heights",
            "state": "OH",
            "postal_code": "441308491",
            "country_code": "US",
            "telephone_number": "216-260-3363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-28",
        "last_updated": "2026-09-27",
        "certification_date": "2026-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2512560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2864093",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.