Nicole Porter, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

110131 Issued in CA

Practice address

24995 Ben Taylor Rd
Colfax, CA 95713-9556

Phone

(530) 346-3290

NPI assigned

Dec 14, 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

Practice roles

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.

• Placer Union High School District

  • Local Education Agency (LEA)
  • Auburn, CA
  • NPI 1104961721
  NPD (past)

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1972371425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 NEW AIRPORT RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956039596",
            "telephone_number": "530-204-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24995 BEN TAYLOR RD",
            "city": "COLFAX",
            "state": "CA",
            "postal_code": "957139556",
            "telephone_number": "530-346-3290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23319 Foresthill Rd",
            "address_purpose": "LOCATION",
            "city": "Foresthill",
            "state": "CA",
            "postal_code": "956319229",
            "country_code": "US",
            "telephone_number": "530-346-3290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-14",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "110131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Ann Mayer
• Mountain Side Behavioral Health LLC (Restoration Recovery Center)
• Mountain Side Behavioral Health LLC
• Gavin O'Sullivan
• Lee Allen Pollock
• Sarah Potter
• Rebecca Marie Somervell Quentmeyer, SLP CCC-M.A.
• Rebecca Rodriguez, RDH
• Ruth Ross, RN BSN
• Julie Ruminson, RDH

• Clinical Social Worker in Colfax, CA
• Providers in Colfax, 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 Oct 4, 2024; 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.