Nicole Carlson, LCSW is a medicare enrolled "Social Worker - Clinical" in Tempe, Arizona. She graduated from nursing school in 2014 and has 10 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Crisis Preparation And Recovery Inc and her current practice location is
2120 S Mcclintock Dr Ste 105, Tempe, Arizona. You can reach out to her office (for appointments etc.) via phone at
(480) 804-0326.
Nicole Carlson is licensed to practice in Arizona (license number LCSW-19986) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1427556240.
Provider's Profile
| Full Name | Nicole Carlson |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 10 Years |
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| Location | 2120 S Mcclintock Dr Ste 105, Tempe, Arizona |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Nicole Carlson graduated from nursing school in 2014
NPI Data:
- NPI Number: 1427556240
- Provider Enumeration Date: 01/26/2018
- Last Update Date: 12/16/2022
Medicare PECOS Information:
- PECOS PAC ID: 4183015720
- Enrollment ID: I20211215002135
Medical Identifiers
Medical identifiers for Nicole Carlson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1427556240 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163W00000X | Registered Nurse | 276452 (Arizona) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW-19986 (Arizona) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Crisis Preparation And Recovery Inc | 3173624384 | 32 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nicole Carlson allows following entities to bill medicare on her behalf.
| Entity Name | Crisis Preparation And Recovery Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1588720650
PECOS PAC ID: 3173624384
Enrollment ID: O20070718000308 |
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| Entity Name | Banner Telehealth Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1396492005
PECOS PAC ID: 7113314279
Enrollment ID: O20220420002128 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole Carlson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Nicole Carlson, LCSW
1400 E Southern Ave Ste 735,
Tempe, AZ 85282-5699
Ph: (480) 804-0326 | Nicole Carlson, LCSW
2120 S Mcclintock Dr Ste 105,
Tempe, AZ 85282-2692
Ph: (480) 804-0326 |
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