Nichole Amber Lee Brandon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

95066 Issued in CA

Practice address

853 Central Ave
Shasta Lake, CA 96019-9529

Phone

(530) 410-4259

NPI assigned

Mar 15, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of ShastaGroup PAC ID 8820081581, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• County of Shasta

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Redding, CA
  • NPI 1881692390
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1962743971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 CENTRAL AVE",
            "city": "SHASTA LAKE",
            "state": "CA",
            "postal_code": "960199529",
            "telephone_number": "530-410-4259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 CENTRAL AVE",
            "city": "SHASTA LAKE",
            "state": "CA",
            "postal_code": "960199529",
            "telephone_number": "530-410-4259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2640 Breslauer Way",
            "address_purpose": "LOCATION",
            "city": "Redding",
            "state": "CA",
            "postal_code": "960014246",
            "country_code": "US",
            "telephone_number": "530-225-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "NICHOLE",
        "middle_name": "AMBER LEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-15",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "95066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lerae Ariagno, LMFT, APCC
• Donald Roy Baas, P.T.
• Erin Marie Baas, PT
• Wayne Bann
• Lauren M Bishop, MED, BCBA
• Harold S. Budhram, M.D
• Katie Bullock, LMFT
• Tracy Daniel Campbell, CAS
• Cloe Jay Carpenter
• Cascades Management Company

• Clinical Social Worker in Shasta Lake, CA
• Providers in Shasta Lake, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; 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.