Audrie M Nicholson, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Carthage, Tennessee. Her current practice location is
1314 Main St N, Carthage, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(615) 594-5490.
Audrie M Nicholson is licensed to practice in Tennessee (license number LSW0000008505) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1730763087.
Healthcare Provider's Profile
Full Name | Audrie M Nicholson |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 1314 Main St N, Carthage, Tennessee |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1730763087
- Provider Enumeration Date: 05/11/2021
- Last Update Date: 07/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 7315393600
- Enrollment ID: I20231023002111
Medical Identifiers
Medical identifiers for Audrie M Nicholson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1730763087 | NPI | - | NPPES |
LSW0000008505 | Other | TN | BOARD OF SOCIAL WORKER LICENSURE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | LSW0000008505 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Audrie M Nicholson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Audrie M Nicholson, LCSW 192 Grant Hwy, Gordonsville, TN 38563-4550 Ph: (615) 594-5490 | Audrie M Nicholson, LCSW 1314 Main St N, Carthage, TN 37030-1054 Ph: (615) 594-5490 |
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