KATHERINE K NICKOLAY (LSCSW) – Clinical Social Worker, NPI 1013436955

KATHERINE K NICKOLAY (LSCSW) is a healthcare provider. based in Virginia, Minnesota. specializing in Clinical Social Worker. They hold the professional credentials LSCSW. They hold a License No. 19851 (MN). The NPI Number for KATHERINE K NICKOLAY (LSCSW) is 1013436955

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
KATHERINE K NICKOLAY (LSCSW)
NPI
1013436955
Phone
(218) 749-2881
Address
PO BOX 1188
Enumeration Date
12 September 2017
Last Update Date
23 November 2020

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA, DULUTH SCHOOL OF MEDICINE
Secondary Phone
6512802310
Graduation Year
2009 (17 years ago)
PAC ID
0941576292
Group Practice PAC ID
0941288922
Professional Enrollment ID
I20171101000408
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:8State licenses:2Digital endpointsOther names

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Provider Addresses for KATHERINE K NICKOLAY (LSCSW)

  • Holiday Inn Morgantown - University Area, 1188, Pine View Drive, Tanglewood, Morgantown, Monongalia County, West Virginia, 26505, United States

    VIRGINIA, MN 557921188

    Phone: (218) 749-2881

    Fax: (218) 749-3806

    Type: Mailing

  • Wilder Center, 451, Lexington Parkway North, Hamline-Midway, Saint Paul, Ramsey County, Minnesota, 55104-2008, United States

    SAINT PAUL, MN 551044636

    Phone: (651) 280-2310

    Fax: (651) 280-3995

    Type: Location

  • PO BOX 467

    NEWTON, KS 671140467

    Phone: (316) 284-6400

    Fax: (316) 284-6490

    Type: Mailing

  • 1901 W 1ST ST

    NEWTON, KS 671145010

    Phone: (316) 284-6400

    Fax: (316) 284-6490

    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: 2017-11-01

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
I20171101000408IClinical Social WorkerMNTBD

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 55792)

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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: 0941288922View full group profile
NameSpecialtyState
Mental Health CounselorMN
-MN
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorMN
Clinical PsychologistMN
Marriage And Family TherapistMN
Mental Health CounselorMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

What number should I use to identify KATHERINE K NICKOLAY (LSCSW) for billing?
Administrative and clinical systems typically use NPI 1013436955 for KATHERINE K NICKOLAY (LSCSW).
Does the public listing show KATHERINE K NICKOLAY (LSCSW) as active?
KATHERINE K NICKOLAY (LSCSW)'s NPI record reflects an active status in NPPES.
What services align with KATHERINE K NICKOLAY (LSCSW)'s listing?
KATHERINE K NICKOLAY (LSCSW)'s public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What city is tied to KATHERINE K NICKOLAY (LSCSW)?
The directory associates KATHERINE K NICKOLAY (LSCSW) with Virginia, Minnesota. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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