MEDICARE: JOANNA NICHOLS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW023061	PA
2	1041C0700X	Clinical Social Worker	0904013456	VA

General Provider Information

NPI Number	:	1265199749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA NICHOLS LCSW

Provider Business Mailing Address
First Line	:	2556 E ANN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-4949
Country	:	US
Telephone Number	:	540-819-6415
Fax Number	:

Provider Business Practice Location Address
First Line	:	2556 E ANN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-4949
Country	:	US
Telephone Number	:	540-819-6415
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2021
Last Update Date	:	01/01/2023

Similar Medicare Providers

1306229695 — PROACTIVE SUPPORT COORDINATION AGENCY LLC
Practice Location Address:

4949 FRANKFORD AVE
PHILADELPHIA, PA
19124-2669

Practice Phone: 215-613-6290
Practice Fax:

1598138448 — MAXIMUM HOME HEALTH CARE LLC
Practice Location Address:

4949 FRANKFORD AVE
PHILADELPHIA, PA
19124-2669

Practice Phone: 215-613-6290
Practice Fax:

1427581982 — BELEN QUEREDA BERNABEU
Practice Location Address:

117 S 11TH ST , ROOM 204 PAVILLION
PHILADELPHIA, PA
19107-4949

Practice Phone: 215-503-3876
Practice Fax:

1891292157 — ZIVER SAHIN MD
Practice Location Address:

117 S 11TH ST
PHILADELPHIA, PA
19107-4949

Practice Phone: 215-503-3876
Practice Fax: 215-955-2519

1659869543 — JESUS OMAR RICO CASTILLO MD
Practice Location Address:

117 S 11TH ST
PHILADELPHIA, PA
19107-4949

Practice Phone: 215-503-3876
Practice Fax:

1043796048 — ZHIMIN YUAN
Practice Location Address:

125 S 11TH ST RM 204
PHILADELPHIA, PA
19107-4949

Practice Phone: 215-955-6961
Practice Fax:

Directions to “ JOANNA NICHOLS LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.