Nichole L Nolan, LICSW, LISW-CP is a medicare enrolled "Social Worker - Clinical" provider in Moses Lake, Washington. Her current practice location is
726 Penn Ivy St, Moses Lake, Washington. You can reach out to her office (for appointments etc.) via phone at
(509) 864-0860.
Nichole L Nolan is licensed to practice in South Carolina (license number SW.18040CP) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1457790750.
Healthcare Provider's Profile
| Full Name | Nichole L Nolan |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 726 Penn Ivy St, Moses Lake, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1457790750
- Provider Enumeration Date: 06/19/2013
- Last Update Date: 07/15/2025
Medicare PECOS Information:
- PECOS PAC ID: 9436676145
- Enrollment ID: I20250506003493
Medical Identifiers
Medical identifiers for Nichole L Nolan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457790750 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | LW61470965 (Washington) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW.18040CP (South Carolina) | Primary |
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. Nichole L Nolan allows following entities to bill medicare on her behalf.
| Entity Name | Revive Counseling Spokane Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1316477805
PECOS PAC ID: 7719398510
Enrollment ID: O20201130003100 |
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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. Nichole L Nolan 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 |
|---|
Nichole L Nolan, LICSW, LISW-CP
172 Olde Towne Way Unit 4,
Myrtle Beach, SC 29588-1502
Ph: (509) 864-0860 | Nichole L Nolan, LICSW, LISW-CP
726 Penn Ivy St,
Moses Lake, WA 98837-2790
Ph: (509) 864-0860 |
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