Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

NICOLE MARCOUILLER MSW, LICSW
NPI 1407364565
Social Worker - Clinical in Maple Grove, MN

Q: What is Nicole Marcouiller's NPI number?

The NPI number for Nicole Marcouiller is 1407364565. It was assigned to this individual provider in the NPPES registry on January 10, 2018.

Q: What is Nicole Marcouiller's specialty?

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

Active since January 10, 2018PECOS Enrolled

10150 NIAGARA LN N STE 100, MAPLE GROVE, MN 55369(763) 297-9700 Get Directions Write a Review

NPPES record last updated: September 21, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 21, 2026, Jan 10, 2018 (2 updates tracked since 2018).

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About Nicole Marcouiller Msw, Licsw NPPES

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

NICOLE MARCOUILLER MSW, LICSW (NPI 1407364565) is an individual clinical provider in Maple Grove, Minnesota, licensed in Minnesota (25899) and active in the NPI registry since January 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1407364565

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameNICOLE MARCOUILLERCredential: MSW, LICSW

Location Address10150 NIAGARA LN N STE 100Maple Grove, MN 55369-7588

Mailing Address2550 University Ave W Ste 110nSaint Paul, MN 55114-2001

Phone(763) 297-9700

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateJanuary 10, 2018

Last NPPES UpdateSeptember 21, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 21, 2026

✔ NPI 1407364565 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 MN · 25899

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.

10150 NIAGARA LN N STE 100, Maple Grove, MN 55369

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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

Nicole Marcouiller Msw, Licsw 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 ID2860753449

PECOS Enrollment IDI20180222000029

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 55369 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 $56.00 – $168.28

Typical copayment $0.00 (range $14.00 – $42.07)

Most-billed visit code NA

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

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 9

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

DANIEL P MUNDT

Internal Medicine (Hematology & Oncology)