NIKOLE BOSTON (LCSW) – Clinical Social Worker, NPI 1720599434

NIKOLE BOSTON (LCSW) is a healthcare provider. based in Shade gap, Pennsylvania. specializing in Clinical Social Worker. They hold the professional credentials LCSW. They hold a License No. SW134830 (PA). The NPI Number for NIKOLE BOSTON (LCSW) is 1720599434

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
NIKOLE BOSTON (LCSW)
NPI
1720599434
Phone
(717) 489-2949
Address
11891 NEELYTON RD
Enumeration Date
20 October 2017
Last Update Date
4 August 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7178101974
Graduation Year
2013 (13 years ago)
PAC ID
3971925074
Group Practice PAC ID
3274896949
Professional Enrollment ID
I20200618001343

Contacts

Secure Messaging
nikole@themindfuloasis.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness85
Years active:8State licenses:2Other namesUpdated within 12 months

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Provider Addresses for NIKOLE BOSTON (LCSW)

  • 11891 NEELYTON RD

    SHADE GAP, PA 172559247

    Phone: (717) 489-2949

    Type: Mailing

  • 513, West Chocolate Avenue, Hershey, Dauphin County, Pennsylvania, 17033, United States

    STE 100

    HERSHEY, PA 170331632

    Phone: (717) 810-1974

    Fax: (717) 704-8476

    Type: Mailing

  • Colonial Village Lane, Lancaster County, Pennsylvania, 17605, United States

    LANCASTER, PA 176016745

    Phone: (717) 391-0172

    Fax: (717) 391-7771

    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: 2020-06-18

PECOS data refreshed: 2026-06-15

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
I20200618001343IClinical Social WorkerPATBD

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 17255)

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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: 3274896949View full group profile
NameSpecialtyState
Clinical PsychologistPA

Reviews

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Frequently asked questions

Where can patients find NIKOLE BOSTON (LCSW)'s NPI?
You can confirm NIKOLE BOSTON (LCSW) with NPI 1720599434; it appears in the national provider directory.
Does this profile mean NIKOLE BOSTON (LCSW) is currently active?
Yes — NIKOLE BOSTON (LCSW) appears active in the national provider directory.
Does NIKOLE BOSTON (LCSW) list a primary specialty?
If you are matching referrals, note Clinical Social Worker for NIKOLE BOSTON (LCSW). Clinical services aligned with this taxonomy classification.
Does NIKOLE BOSTON (LCSW) practice in Pennsylvania?
You will see Shade Gap, Pennsylvania on file for NIKOLE BOSTON (LCSW) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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