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NICOLE REYNOLDS SMALL MSW LICSW NPI 1417072356


NPI Information

NPI: 1417072356
Provider Name: NICOLE REYNOLDS SMALL, MSW, LICSW
Classification: Social Worker - 1041C0700X
Entity Type: Individual

Specialization: Clinical

Address:
1005 S 3RD ST
MOUNT VERNON, WA
ZIP 98273
Phone: (360) 419-3612
Get Directions

Nicole Reynolds Small, MSW, LICSW is a clinical social worker in Mount Vernon, WA. The provider is 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. Nicole Reynolds Small, MSW, LICSW NPI is 1417072356. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1005 S 3RD ST
MOUNT VERNON, WA
ZIP 98273-301
Phone: (360) 419-3612
Fax: (360) 419-3605

The enumeration date for this NPI number is 3/20/2007 and was last updated on 1/20/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalASW18384CALIFORNIANo
21041S0200XSocial WorkerSchoolPPSC #060034254CALIFORNIANo
3101Y00000XCounselorRC00058160WASHINGTONNo
41041S0200XSocial WorkerSchool443673RWASHINGTONNo
51041C0700XSocial WorkerClinicalLW 60064972WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PSIX593OTHERCALIFORNIADMH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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