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Patricia M Nichols

Social Worker

Behavioral Health & Social Service Providers

502 S 4th St, Laramie, WY 82070-3704

PECOS Enrollment

This provider is enrolled in PECOS as PATRICIA NICHOLS.

Based on the most recent information from CMS, provider Patricia M Nichols is legally eligible to order and refer claims for DME services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:54 AM.

Profile Details

Provider ID
1407205636
Provider Type
Individual
Full Name
Nichols, Patricia M
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
6/8/2016
Last Updated
5/9/2022

Contact Information

Practice Location

502 S 4th St, Laramie, WY 82070-3704

(307) 755-1000

Unlisted Fax

Mailing Location

502 S 4th St, Laramie, WY 82070-3704

(307) 755-1000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 1419 Wyoming
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License 838 Wyoming

Provider Identifiers

ID	Description	Issuer
ID 1407205636	Description Medicaid	Issuer Unlisted Wyoming

Patricia M Nichols

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Perea, Lawrence D

Culwell, Jayme

Maffei, Kimberly Sue

Gerrish, Olivia

Bursac, Sara

Patricia M Nichols

Kimberly Maffei Lcsw, Llc

Harris, Tracey

Pfister, Morgan

Mir, Jesse A