Nicole Marie Liedtke, LCSW, LCAC is a medicare enrolled "Social Worker - Clinical" provider in Fishers, Indiana. Her current practice location is
14074 Trade Center Dr, Ste 220, Fishers, Indiana. You can reach out to her office (for appointments etc.) via phone at
(317) 775-7797.
Nicole Marie Liedtke is licensed to practice in Indiana (license number 34005950A) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1740505460.
Healthcare Provider's Profile
| Full Name | Nicole Marie Liedtke |
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| Gender | Female |
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| Speciality | |
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| Experience | Years |
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| Location | 14074 Trade Center Dr, Fishers, Indiana |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Nicole Marie Liedtke attended and graduated from in
NPI Data:
- NPI Number: 1740505460
- Provider Enumeration Date: 04/06/2010
- Last Update Date: 12/10/2020
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Nicole Marie Liedtke such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1740505460 | NPI | - | NPPES |
| 000001111107 | Other | IN | ANTHEM BLUE CROSS BLUE SHIELD |
| 34005950A | Other | IN | LCSW |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 87001005A (Indiana) | Secondary |
| 1041C0700X | Social Worker - Clinical | 34005950A (Indiana) | 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. Nicole Marie Liedtke 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 |
|---|
Nicole Marie Liedtke, LCSW, LCAC
3645 N Briarwood Ln, Ste A,
Muncie, IN 47304-5337
Ph: (765) 289-5520 | Nicole Marie Liedtke, LCSW, LCAC
14074 Trade Center Dr, Ste 220,
Fishers, IN 46038-4575
Ph: (317) 775-7797 |
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