AUDREY NICHOLSON (LISW) – Clinical Social Worker, NPI 1528472834

AUDREY NICHOLSON (LISW) is a healthcare provider. based in Fremont, Ohio. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LISW. They hold a License No. I.1440230 (OH). The NPI Number for AUDREY NICHOLSON (LISW) is 1528472834

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
AUDREY NICHOLSON (LISW)
NPI
1528472834
Phone
(419) 334-6619
Address
715 S TAFT AVE
Enumeration Date
13 June 2014
Last Update Date
12 September 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5675253311
Graduation Year
2010 (16 years ago)
PAC ID
4082839626
Group Practice PAC ID
3375896806
Professional Enrollment ID
I20140715001764
Address ID
OH458403471FI124XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

2,650 CLINICAL SOCIAL WORKER in OH

Provider Addresses for AUDREY NICHOLSON (LISW)

  • 715 S TAFT AVE

    FREMONT, OH 434203237

    Phone: (419) 334-6619

    Fax: (419) 334-6663

    Type: Mailing

  • 1100 E MAIN CROSS ST

    FINDLAY, OH 458406381

    Phone: (419) 424-1471

    Fax: (419) 424-1413

    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: 2014-07-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-07-31 (1044 days ago).

Enrollment records

1

Earliest due date

2023-07-31

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
I20140715001764IClinical Social WorkerOH2023-07-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 43420)

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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: 3375896806View full group profile
NameSpecialtyState
Clinical Social WorkerOH
Clinical Social WorkerOH
Clinical PsychologistOH
Clinical Social WorkerOH
Clinical Social WorkerOH

Reviews

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Frequently asked questions

What federal number belongs to AUDREY NICHOLSON (LISW)?
The federal identifier for AUDREY NICHOLSON (LISW) is NPI 1528472834.
Is AUDREY NICHOLSON (LISW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does AUDREY NICHOLSON (LISW) work in?
You can think of AUDREY NICHOLSON (LISW) as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where does public data place AUDREY NICHOLSON (LISW)?
The snapshot lists Fremont, Ohio for AUDREY NICHOLSON (LISW); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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