Nickolaus King, LCSW-C is a medicare enrolled "Social Worker - Clinical" provider in Edgewood, Maryland. His current practice location is
2120 Emmorton Park Rd Ste E, Edgewood, Maryland. You can reach out to his office (for appointments etc.) via phone at
(443) 402-1925.
Nickolaus King is licensed to practice in Maryland (license number 28530) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1124758602.
Healthcare Provider's Profile
Full Name | Nickolaus King |
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Gender | Male |
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Speciality | Social Worker - Clinical |
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Location | 2120 Emmorton Park Rd Ste E, Edgewood, Maryland |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1124758602
- Provider Enumeration Date: 06/16/2022
- Last Update Date: 08/31/2025
Medicare PECOS Information:
- PECOS PAC ID: 0749711281
- Enrollment ID: I20241008001512
Medical Identifiers
Medical identifiers for Nickolaus King such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124758602 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | Q1-0012675 (Delaware) | Secondary |
1041C0700X | Social Worker - Clinical | 44SC06544300 (New Jersey) | Secondary |
1041C0700X | Social Worker - Clinical | CW025578 (Pennsylvania) | Secondary |
1041C0700X | Social Worker - Clinical | Q1-0012675 (Delaware) | Secondary |
1041C0700X | Social Worker - Clinical | 28530 (Maryland) | 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. Nickolaus King allows following entities to bill medicare on his behalf.
Entity Name | Key Point Health Services, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1497760847 PECOS PAC ID: 1052307774 Enrollment ID: O20040420001514 |
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Entity Name | Reclaim And Restore Healing Company |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1699559179 PECOS PAC ID: 9739620717 Enrollment ID: O20240918000057 |
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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. Nickolaus King 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 |
Nickolaus King, LCSW-C 901 N Barrett Ln, Newark, DE 19702-6907 Ph: (410) 656-9010 | Nickolaus King, LCSW-C 2120 Emmorton Park Rd Ste E, Edgewood, MD 21040-1066 Ph: (443) 402-1925 |
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