NICKOLAS B DAVIS (PHD, LCSW, LICSW) – Clinical Social Worker, NPI 1558645341

NICKOLAS B DAVIS (PHD, LCSW, LICSW) is a healthcare provider. based in Lake mary, Florida. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials PHD, LCSW, LICSW. They hold a License No. SW11627 (FL). The NPI Number for NICKOLAS B DAVIS (PHD, LCSW, LICSW) is 1558645341

Main info

Male
6 Years Of Experience
Name
NICKOLAS B DAVIS (PHD, LCSW, LICSW)
NPI
1558645341
Phone
(407) 320-9348
Address
450 TECHNOLOGY PARK
Enumeration Date
28 September 2011
Last Update Date
22 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2020 (6 years ago)
PAC ID
4688901002
Professional Enrollment ID
I20260409001986
Address ID
FL331301807MI66XXXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:14State licenses:1Digital endpointsOther names

3,374 CLINICAL SOCIAL WORKER in FL

Provider Addresses for NICKOLAS B DAVIS (PHD, LCSW, LICSW)

  • 450 TECHNOLOGY PARK

    LAKE MARY, FL 327466203

    Phone: (407) 320-9348

    Type: Mailing

  • 4001 W MCNICHOLS ROAD

    BRIGGS 315

    DETROIT, MI 48221

    Phone:

    Type: Mailing

  • 66 W FLAGLER ST STE 900

    MIAMI, FL 331301807

    Phone: (407) 320-9348

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-02-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 8 Medicare enrollment records; no due dates published yet.

Enrollment records

8

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190808000329IClinical Social WorkerFLTBD
I20240319004075IClinical Social WorkerNJTBD
I20250208000022IClinical Social WorkerCOTBD
I20250211001114IClinical Social WorkerWATBD
I20250211001900IClinical Social WorkerTXTBD
I20250326001035IClinical Social WorkerMITBD
I20251124001491IClinical Social WorkerDCTBD
I20260219002286IClinical Social WorkerNDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32746)

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Reviews

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Frequently asked questions

What is the standard ID for NICKOLAS B DAVIS (PHD, LCSW, LICSW) in the U.S.?
In the U.S., NICKOLAS B DAVIS (PHD, LCSW, LICSW) is identified by NPI 1558645341.
Does the public listing show NICKOLAS B DAVIS (PHD, LCSW, LICSW) as active?
NICKOLAS B DAVIS (PHD, LCSW, LICSW)'s NPI record reflects an active status in NPPES.
What services align with NICKOLAS B DAVIS (PHD, LCSW, LICSW)'s listing?
NICKOLAS B DAVIS (PHD, LCSW, LICSW)'s public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Can patients visit NICKOLAS B DAVIS (PHD, LCSW, LICSW) in Lake Mary, Florida?
For routing, start with Lake Mary, Florida for NICKOLAS B DAVIS (PHD, LCSW, LICSW), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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