SAMANTHA NICHOLSON


Address: 9480 Princeton Square Blvd S, Apr 2411, Jacksonville, FL 32256-0302
Phone: 3476457798

SAMANTHA NICHOLSON (NPI# 1992161087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1992161087
Entity Type Individual
Full Name SAMANTHA NICHOLSON
Practice Address 9480 Princeton Square Blvd S
Apr 2411
Jacksonville
FL 32256-0302
Mailing Address 2532 Townsquare Dr
Jacksonville
FL 32216-3394
Practice Telephone 3476457798
Mailing Telephone 3476457798
Enumeration Date 2016-01-06
Last Update Date 2019-10-03
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 104100000X Social Worker Behavioral Health & Social Service Providers
Y 1041C0700X Social Worker
Specialization: Clinical
10090 FL Behavioral Health & Social Service Providers

Other Providers SAMANTHA NICHOLSON

NPI Name Taxonomy Address Enumeration
1356693782 Samantha Renee Nicholson Marriage & Family Therapist 4310 Ne Killingsworth St, Portland, OR 97218-1404 2012-10-09

Office Location

Street Address 9480 PRINCETON SQUARE BLVD S
APR 2411
City JACKSONVILLE
State FL
Zip Code 32256-0302

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Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

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]

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NPI Name Taxonomy Address Enumeration
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1689282626 Andrea Kristin Perkinson Social Worker 128 Plow Point Ln, Jacksonville, NC 28546-9591 2020-07-15
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Competitor

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City JACKSONVILLE
Zip Code 32256

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Dataset Information

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.

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