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AUTUMN NICKELSON NPI 1619142767


NPI Information

NPI: 1619142767
Provider Name: AUTUMN NICKELSON
Classification: Social Worker - 1041C0700X
Entity Type: Individual

Specialization: Clinical

Address:
1222 10TH STREET, SUITE 211
NORTHWEST CENTER FOR BEHAVIORAL HEALTH
WOODWARD, OK
ZIP 73801
Phone: (580) 571-3231
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Autumn Nickelson is a clinical social worker in Woodward, OK. 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. Autumn Nickelson NPI is 1619142767. 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:

1222 10TH STREET, SUITE 211
NORTHWEST CENTER FOR BEHAVIORAL HEALTH
WOODWARD, OK
ZIP 73801
Phone: (580) 571-3231
Fax: (580) 571-8609

The enumeration date for this NPI number is 4/29/2008 and was last updated on 11/30/2016.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1106H00000XMarriage & Family TherapistNo
21041C0700XSocial WorkerClinical3847OKLAHOMAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200407870MEDICAIDOKLAHOMA

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: 5/5/2024

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