Mignon Elisse McNicol, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I2153 Issued in NM

Practice address

713 6TH St
Las Vegas, NM 87701

Phone

(505) 429-0588

Fax

(505) 425-6236

NPI assigned

Dec 5, 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

Other identifiers 1

Other names 1

• Ms. Lela Mignon McNicol Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922166651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 6TH ST",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "87701",
            "telephone_number": "505-429-0588",
            "fax_number": "505-425-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 6TH ST",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "87701",
            "telephone_number": "505-429-0588",
            "fax_number": "505-425-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNICOL",
        "first_name": "MIGNON",
        "middle_name": "ELISSE",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I2153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000F5787",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LELA",
            "last_name": "MCNICOL",
            "middle_name": "MIGNON",
            "prefix": "MS.",
            "credential": "LISW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Pamela McCrary, LBSW
• Rose Marie McDonald, CNP
• McFall Physical Therapy, LLC
• Michael L McFall, RPT
• Cindy Ann McLeod, MA
• Meadow City Assisted Living LLC
• Bernadine Joann Medina
• Denise A Medina, MA LMHC
• Mark J Medina, CSW
• Melissa Williamson

• Clinical Social Worker in Las Vegas, NM
• Providers in Las Vegas, NM by specialty
• Clinical Social Worker in New Mexico

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.