Kelly Nichols, LCSW-R
NPI 1649640764 · Clinical Social Worker · Fayetteville, NY
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kelly Nichols, LCSW-R is a Clinical Social Worker provider in Fayetteville, NY (NPI 1649640764).
Provider details
- NPI number
- 1649640764
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW-R
- Sex
- Female
- Sole proprietor
- Yes
- License
- 73070425 (NY)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2015-10-01
- Last updated
- 2015-10-01
Frequently asked questions
- What is Kelly Nichols's NPI number?
- Kelly Nichols's National Provider Identifier (NPI) is 1649640764, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kelly Nichols's specialty?
- Kelly Nichols is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Kelly Nichols located?
- Kelly Nichols's practice location on file with NPPES is 215 Dawley Rd, Fayetteville, NY 13066-2546.
- What is Kelly Nichols's phone number?
- The practice phone number listed in the NPPES registry for Kelly Nichols is (315) 420-6293.
- Does Kelly Nichols accept Medicare?
- Kelly Nichols is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kelly Nichols's NPI active?
- Yes — Kelly Nichols's NPI (1649640764) is active in the NPPES registry as of the last update on 2015-10-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.