NICHOLAS DRAKE (LICSW) – Social Worker, NPI 1417349176

NICHOLAS DRAKE (LICSW) is a healthcare provider. based in Eaton rapids, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. LW61196656 (WA). The NPI Number for NICHOLAS DRAKE (LICSW) is 1417349176

Main info

Male
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLAS DRAKE (LICSW)
NPI
1417349176
Phone
Not provided
Address
1473 WATER ST
Enumeration Date
4 March 2015
Last Update Date
13 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3603773776
Graduation Year
2018 (8 years ago)
PAC ID
3476095969
Group Practice PAC ID
9436044781
Professional Enrollment ID
I20240612001948
Address ID
WA983663778PO320XXBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness85
Years active:11State licenses:2Digital endpointsOther names

4,821 CLINICAL SOCIAL WORKER in MI

Provider Addresses for NICHOLAS DRAKE (LICSW)

  • 1473 WATER ST

    EATON RAPIDS, MI 488271866

    Phone:

    Type: Mailing

  • 19586 10TH AVE NE

    POULSBO, WA 983707332

    Phone: (517) 410-7430

    Type: Location

  • 27475 GAMBLE BAY RD NE

    KINGSTON, WA 983469539

    Phone: (517) 410-7430

    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: 2024-06-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20240612001948IClinical Social WorkerWATBD

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 48827)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436044781View full group profile
NameSpecialtyState
-WA
Physician AssistantWA
-WA
Mental Health CounselorWA
Nurse PractitionerWA
Internal MedicineCA
-WA
Physician AssistantCA
Physician AssistantWA
Nurse PractitionerWA

Reviews

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Frequently asked questions

How do payers reference NICHOLAS DRAKE (LICSW)?
For NICHOLAS DRAKE (LICSW), use NPI 1417349176 as the unique 10-digit identifier.
Is NICHOLAS DRAKE (LICSW) still an active registrant?
NICHOLAS DRAKE (LICSW) carries an active NPI according to the public dataset.
What clinical focus is listed for NICHOLAS DRAKE (LICSW)?
At a glance, NICHOLAS DRAKE (LICSW) is tied to Social Worker. Clinical services aligned with this taxonomy classification.
Is NICHOLAS DRAKE (LICSW) associated with Eaton Rapids?
Public fields place NICHOLAS DRAKE (LICSW) around Eaton Rapids, Michigan. Always confirm the exact site before visiting.
What does 5 location(s) imply?
5 practice locations appear in the available data.