MRS. KELLY HANNON NICHOLS (NPI# 1649640764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649640764 |
| Entity Type | Individual |
| Full Name | MRS. KELLY HANNON NICHOLS |
| Other Name | KELLY HANNON |
| Credential | LCSW-R |
| Practice Address |
215 Dawley Rd Fayetteville NY 13066-2546 |
| Practice Telephone | 3154206293 |
| Practice Fax Number | 3156377576 |
| Mailing Telephone | 3154206293 |
| Mailing Fax Number | 3156377576 |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2015-10-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
73070425 | NY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659881530 | Kelly Nichols | Nurse Practitioner | 140 E Delaware Ave, Newark, DE 19711-4605 | 2017-10-05 |
| 1578803714 | Kelly M Nichols | Licensed Practical Nurse | 829 Scotch Mountain Rd, Delhi, NY 13753-2321 | 2013-02-26 |
| 1851396691 | Kelly B Nichols | Obstetrics & Gynecology | 8380 N. Tullis Avenue, Suite 300, Ste 310, Kansas City, MO 64158-5114 | 2005-06-17 |
| 1245889005 | Kelly Ann Nichols | Registered Nurse | 4 Hickory Ridge Rd Ste 600, Hillsboro, MO 63050-5117 | 2019-09-04 |
| 1447709159 | Kelly Nichols | Nurse Practitioner | 2601 Kentucky Ave, Suite 300, Paducah, KY 42003-3817 | 2016-09-23 |
| 1104371418 | Kelly Amanda Merritt Nichols | Nurse Anesthetist, Certified Registered | 5200 Harry Hines Blvd, Dallas, TX 75235 | 2016-08-17 |
| 1235587452 | Kelly Nichols | Behavioral Analyst | 528 E Spokane Falls Blvd, Suite 14, Spokane, WA 99202-5081 | 2016-05-27 |
| 1629462627 | Kelly Nichols | Obstetrics & Gynecology | 101 Dudley St, Providence, RI 02905-2401 | 2015-03-27 |
| 1306108824 | Kelly A. Nichols | Nurse Anesthetist, Certified Registered | 700 S Park St, Madison, WI 53715-1830 | 2012-06-11 |
| 1295093748 | Kelly Ann Nichols | Audiologist | 1001 James St, Syracuse, NY 13203-2789 | 2012-05-02 |
| Street Address |
215 DAWLEY RD |
| City | FAYETTEVILLE |
| State | NY |
| Zip Code | 13066-2546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819963 | Word Wellness Center, LLC | Psychologist | 6836 E Genesee Street, Suite A, Fayetteville, NY 13066 | 2019-03-05 |
| 1629529060 | Lorna Boyer Chase | Marriage & Family Therapist | 109 White Heron Circle, Fayetteville, NY 13066 | 2016-10-20 |
| 1699221432 | Roman Batyuk | Nurse Practitioner | 4100 Medical Center Drive, Fayetteville, NY 13066 | 2016-08-31 |
| 1427405133 | National Eye Care, Inc | Optometrist | 5160 Kinloch Circle, Fayetteville, NY 13066 | 2016-05-23 |
| 1013375328 | Kristin Kukenberger | Chiropractor | 7000 E Genesee St Bldg B, Fayetteville, NY 13066 | 2016-02-01 |
| 1124394671 | Susan Hartman Brenizer | Marriage & Family Therapist | 7000 E Genesee St Lyndon Office Park, Bldg. A, Second Floor (upper Level), Fayetteville, NY 13066 | 2012-03-29 |
| 1245541432 | Rene L Converse | Occupational Therapist | 7200 E. Genesee Street, Fayetteville, NY 13066 | 2010-06-23 |
| 1689815805 | Menorah Park Group Residents | Clinic/Center | 12 Jamar Drive, Dewitt, NY 13066 | 2009-03-18 |
| 1063677458 | John Marcena Glezen | Obstetrics & Gynecology | 1 The Gazebo, Fayetteville, NY 13066 | 2008-07-24 |
| 1629232418 | Tucker Martin Harris | Otolaryngology | 4000 Medical Center Dr # 117, Fayetteville, NY 13066 | 2008-07-11 |
| Find all providers in zip 13066 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484201 | Torrie Luciana Powell | Social Worker | 3526 Standard Dr, Fayetteville, NC 28306-8089 | 2020-10-15 |
| 1053918169 | Activelife Counseling, LLC | Social Worker | 1792 E Joyce Blvd Ste 105, Fayetteville, AR 72703-5253 | 2020-10-02 |
| 1861004996 | Roderick Eugene Brown Jr. | Social Worker | 2014 Litho Pl Ste 200, Fayetteville, NC 28304-2518 | 2020-08-19 |
| 1427667278 | Valerie Russell | Social Worker | 6209 Lakehaven Dr, Fayetteville, NC 28304-0610 | 2020-07-28 |
| 1942822671 | Alexis Oneal Vestal | Social Worker | 723 Athens Ave, Fayetteville, NC 28301-4800 | 2020-05-15 |
| 1346862281 | Heather Marie Sroka | Social Worker | 690 N Reilly Rd # F, Fayetteville, NC 28303-5724 | 2020-05-14 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1730716887 | Denise Rodriguez | Social Worker | 2885 N Brookbury Xing, Fayetteville, AR 72703-4377 | 2020-03-26 |
| 1982239877 | Alicia Story | Social Worker | 3035 Boone Trail Ext, Fayetteville, NC 28304-3992 | 2020-03-11 |
| 1053959619 | Benlyd Colon | Social Worker | 2940 Breezewood Ave Ste 101-201, Fayetteville, NC 28303-5520 | 2019-12-13 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 13066 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.