NICOLE MARIE MCKIBBAN LCSW
NPI 1063086445
Social Worker - Clinical in Charlotte, NC

Q: What is Nicole Mckibban's NPI number?

The NPI number for Nicole Mckibban is 1063086445. It was assigned to this individual provider in the NPPES registry on May 19, 2021. The provider is also known as Nicole Marie Baham.

Q: What is Nicole Mckibban's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Mckibban was last updated on June 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 19, 2021

5200 PARK RD STE 218B, CHARLOTTE, NC 28209(866) 700-1606 Get Directions Write a Review

NPPES record last updated: June 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 11, 2024, Dec 13, 2023, Jun 2, 2021 and 1 more (4 updates tracked since 2021).

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About Nicole Marie Mckibban Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE MARIE MCKIBBAN LCSW (NPI 1063086445) is an individual clinical provider in Charlotte, North Carolina, licensed in North Carolina (C017257) and active in the NPI registry since May 2021.

NPPES Registry Identity

NPI1063086445

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameNICOLE MARIE MCKIBBANCredential: LCSW

Location Address5200 PARK RD STE 218BCharlotte, NC 28209-3650

Mailing Address5200 Park Rd Ste 218bCharlotte, NC 28209-3650 · (866) 700-1606

Phone(866) 700-1606

Sole ProprietorYes

Enumeration DateMay 19, 2021

Last NPPES UpdateJune 11, 20244 updates tracked since enumeration

NPPES CertifiedJune 11, 2024

✔ NPI 1063086445 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in NC · C017257

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

5200 PARK RD STE 218B, Charlotte, NC 28209

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Other Names 1

Former Name (1)Nicole Marie Baham

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDSEY YVETTE DONATIEN LCMHC

Counselor (Professional)