Andrew John Nicholls, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60910713 Issued in WA

Practice address

1660 S Columbian Way
Seattle, WA 98108-1532

Phone

(206) 764-2756

NPI assigned

Sep 5, 2013

Sex

Male

Sole proprietor

No

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": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1962837252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 PINE ST",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 S COLUMBIAN WAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081532",
            "telephone_number": "206-764-2756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1328 2nd St",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904011122",
            "country_code": "US",
            "telephone_number": "310-576-1308 x1228",
            "fax_number": "310-576-1027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLLS",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-05",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60910713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter Paul Nichol, M.D.
• Nicholas Koogler DDS PLLC
• Nicholas Maniatis DMD PLLC
• Larry D Nicholas, MA LMHC
• Tristan Irene Nicholas, MSW, RC
• Mary Nicholls
• Andrew Nichols, LMHC
• Bridget Ann Nichols, RD
• Cara Nichols
• Clara Antionette Nichols, CDPT

• Clinical Social Worker in Seattle, WA
• Providers in Seattle, 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 Jun 4, 2020; 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.