LYSSA NICKLE (NPI# 1821480799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821480799 |
| Entity Type | Individual |
| Full Name | LYSSA NICKLE |
| Credential | L.C.S.W. |
| Practice Address |
3021 Schroer Dr Valdosta GA 31602-4067 |
| Practice Telephone | 2296302499 |
| Mailing Telephone | 2296302499 |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2015-03-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CSW004376 | GA | Behavioral Health & Social Service Providers |
| Street Address |
3021 SCHROER DR |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-4067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| 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 |
|---|---|---|---|---|
| 1326647629 | Sheba Phillips | Social Worker | 2402 Orlando Dr, Valdosta, GA 31602-1921 | 2020-10-19 |
| 1093323982 | Jessica Mcconnell Duke | Social Worker | 3860 Heather Way, Valdosta, GA 31605-7881 | 2020-07-16 |
| 1225651540 | Jaqueline Rose Vallina | Social Worker | 340 Gonwood Cir, Valdosta, GA 31602-1631 | 2020-05-20 |
| 1821610452 | Bridgeway Recovery Center, LLC | Social Worker | 1102 Williams St, Valdosta, GA 31601-4041 | 2020-05-18 |
| 1477032563 | Anissa White | Social Worker | 3708 Knights Mill Dr, Valdosta, GA 31605-6582 | 2018-08-09 |
| 1578009254 | Martha M. Giddings | Social Worker | 3790 Old Us Highway 41 N, Ste A, Valdosta, GA 31602-6865 | 2017-01-18 |
| 1366825010 | William Brantley Wheeler | Social Worker | 1503 E Park Ave Apt D10, Valdosta, GA 31602-5304 | 2015-06-30 |
| 1730503632 | Center for Personal and Family Growth LLC | Social Worker | 2704 N Oak St Bldg L, Valdosta, GA 31602-1790 | 2014-02-12 |
| 1376893131 | Catherine Lee Hoover | Social Worker | 3036 Academy Dr, Valdosta, GA 31605-4712 | 2012-09-19 |
| 1528323334 | Tracy W Corbett, Lcsw, PC | Social Worker | 1013 Cherry Creek Dr, Valdosta, GA 31605-5922 | 2012-07-08 |
| Find all providers in VALDOSTA | ||||
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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.