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Anne B Nicholson

Social Worker

Behavioral Health & Social Service Providers

11818 Rock Landing Dr Ste 101, Newport News, VA 23606-4394

PECOS Enrollment

This provider is enrolled in PECOS as ANNE NICHOLSON.

Based on the most recent information from CMS, provider Anne B Nicholson is legally eligible to order and refer claims for Part B and DME services only.

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

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1669484994
Provider Type
Individual
Full Name
Nicholson, Anne B
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
8/13/2006
Last Updated
8/19/2025

Contact Information

Practice Location

11818 Rock Landing Dr Ste 101, Newport News, VA 23606-4394

(757) 595-3900

Unlisted Fax

Mailing Location

PO Box 1069, Grafton, VA 23692

(757) 877-9140

(757) 877-3925

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 0904003498 Virginia
Code 104100000X	Description Social Worker Behavioral Health & Social Service Providers	License 0904003498 Virginia

Provider Identifiers

ID	Description	Issuer
ID 517071	Description Other	Issuer VALUE OPTIONS
ID 268398	Description Other	Issuer ANTHEM Virginia
ID 010039967	Description Medicaid	Issuer Unlisted Virginia

Anne B Nicholson

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

ID

Description

Issuer

ID

Description

Issuer

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Mensah, Chad

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Kelly, Bonnie Jeanne