Nicole Black, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2025034325 Issued in MO

Practice address

5505 Carrick CT
Columbia, MO 65203-5156

Phone

(610) 675-5326

NPI assigned

Jul 12, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1942989645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 CARRICK CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035156",
            "telephone_number": "610-675-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 CARRICK CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035156",
            "telephone_number": "610-675-5326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652015276",
            "country_code": "US",
            "telephone_number": "573-228-1922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2025034325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William F Birkby, M.D.
• Caleb Bischoff, DO
• Shianne Bisig
• Tate Bittiker, PHARM D.
• Benjamin Thomas Black, M.D.
• Janna Blackburn, RN
• Joel M Blackburn, D.O.
• Jameson Tanner Blackford, PHARMD
• Heidi Annette Blackstun, MSW, LCSW, MBA
• Deborah Ann Blain, CHIROPRACTOR

• Clinical Social Worker in Columbia, MO
• Providers in Columbia, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.