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JACOB NICHOLLS LCSW
NPI 1134907942
Social Worker - Clinical in Southbury, CT

Active since September 21, 2023PECOS EnrolledAccepts Medicare Assignment
519 HERITAGE RD STE 2A5, SOUTHBURY, CT 06488(203) 568-5923 Get Directions Write a Review

NPPES record last updated: September 21, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacob Nicholls Lcsw NPPES

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

JACOB NICHOLLS LCSW (NPI 1134907942) is an individual clinical provider in Southbury, Connecticut, licensed in Connecticut (13366) and active in the NPI registry since September 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1134907942
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJACOB NICHOLLSCredential: LCSW
Location Address519 HERITAGE RD STE 2A5Southbury, CT 06488-6694
Mailing Address11 Linron DrDanbury, CT 06810-6409 · (203) 628-3508
Phone(203) 568-5923
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateSeptember 21, 2023
NPPES CertifiedSeptember 21, 2023
✔ NPI 1134907942 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 CT · 13366
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.
519 HERITAGE RD STE 2A5, Southbury, CT 06488
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacob Nicholls Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880104082
PECOS Enrollment IDI20250606002709
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06488 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $60.82 – $183.10
Typical copayment $0.00 (range $15.20 – $45.77)
Most-billed visit code NA
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

SOUTHBURY ADOLESCENT AND YOUNG ADULT COUNSELING CENTER
Counselor (Mental Health)
519 HERITAGE RD STE 2A5
SOUTHBURY, CT 06488
Naugatuck Valley Planning Region (203) 568-5923
MR. BRENDAN STACK LPC, LADC
Counselor (Professional)
519 HERITAGE RD STE 2A5
SOUTHBURY, CT 06488
Naugatuck Valley Planning Region (518) 610-4528

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Nicholls's NPI number?

The NPI number for Jacob Nicholls is 1134907942. It was assigned to this individual provider in the NPPES registry on September 21, 2023.

Where is Jacob Nicholls located?

Jacob Nicholls practices at 519 Heritage Rd Ste 2a5, Southbury, CT 06488. The listed phone number is (203) 568-5923.

What is Jacob Nicholls's specialty?

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

Is Jacob Nicholls enrolled in Medicare?

Yes. Jacob Nicholls is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jacob Nicholls accept?

Health plans from Providence Health Plan list Jacob Nicholls as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacob Nicholls was last updated on September 21, 2023. 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.