- Practice location
- 3993 Vt Route 100, Granville, VT 05747-9747
- Phone
- 206-818-2439
- Fax
- —
- Last updated
- June 11, 2024
Stefan Nickum is a Social Worker, Clinical based in Granville, VT. Stefan Nickum practices in Granville, VT and has the professional credentials of LICSW. The NPI Number for Stefan Nickum is 1518709559 and holds a License No. 089.0134493 (VT). The current practice location address for Stefan Nickum is 3993 Vt Route 100, Granville, VT 05747-9747 and can be reached out via phone at 206-818-2439.
Provider Profile Details
- NPI Number
- 1518709559
- Provider Name
- Stefan Nickum
- Credential
- LICSW
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 3993 Vt Route 100, Granville, VT 05747-9747
- Phone Number
- 206-818-2439
- Primary Taxonomy
- Social Worker, Clinical · 1041C0700X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- June 11, 2024
- Last Update Date
- June 11, 2024
- Certification Date
- June 11, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 3993 Vt Route 100
Granville, VT 05747-9747 - City
- Granville
- State
- Vermont
- Zip
- 05747-9747
- Phone Number
- 206-818-2439
Provider Business Mailing Address Details
- Address
- 3993 Vt Route 100
Granville, VT 05747-9747 - City
- Granville
- State
- VT
- Zip
- 05747-9747
- Phone Number
- 206-818-2439
License Information
- License Number
- 089.0134493
- License State
- VT
- Taxonomy
- Social Worker, Clinical · 1041C0700X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Social Worker, Clinical providers near Granville, VT
View all Social Worker, Clinical providers in Granville →Frequently Asked Questions
What is the NPI number of Stefan Nickum, LICSW?
The NPI number of Stefan Nickum, LICSW is 1518709559. It was assigned on June 11, 2024 and is currently active in the NPPES registry.
What is the specialty of Stefan Nickum, LICSW?
Stefan Nickum, LICSW is registered under the primary taxonomy Social Worker, Clinical (code 1041C0700X), licensed in VT under license number 089.0134493.
Where does Stefan Nickum, LICSW practice?
The practice location is 3993 Vt Route 100, Granville, VT 05747-9747. The office can be reached at 206-818-2439 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1518709559 directly on the NPPES registry website.