NICOLE M. PETTIBONE LMSW
NPI 1679969752
Social Worker in Southfield, MI

Q: What is Nicole Pettibone's NPI number?

The NPI number for Nicole Pettibone is 1679969752. It was assigned to this individual provider in the NPPES registry on April 15, 2015.

Q: What is Nicole Pettibone's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Pettibone was last updated on January 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 April 15, 2015PECOS EnrolledAccepts Medicare Assignment

22255 GREENFIELD RD STE 550, SOUTHFIELD, MI 48075(844) 576-9226 Get Directions Write a Review

NPPES record last updated: January 20, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jan 20, 2020, Jan 11, 2020 (2 updates tracked since 2020).

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About Nicole M. Pettibone Lmsw NPPES

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

NICOLE M. PETTIBONE LMSW (NPI 1679969752) is an individual social worker in Southfield, Michigan, licensed in Michigan (6801097713) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1679969752

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameNICOLE M. PETTIBONECredential: LMSW

Location Address22255 GREENFIELD RD STE 550Southfield, MI 48075-3730

Mailing Address2800 Livernois RdTroy, MI 48083-1215

Phone(844) 576-9226

Sole ProprietorYes

Medical School CMSOtherGraduated 2014

Enumeration DateApril 15, 2015

Last NPPES UpdateJanuary 20, 20202 updates tracked since enumeration

✔ NPI 1679969752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

License✔ Licensed in MI · 6801097713

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 6801097713 (MI)

22255 GREENFIELD RD STE 550, Southfield, MI 48075

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Other Identifiers 1

Other6801097713MI · State Of Michigan - Michigan Department Of Licensing & Regulatory Affairs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.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

Nicole M. Pettibone Lmsw 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 ID244590578

PECOS Enrollment IDI20180207000465

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.

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 Nicole Pettibone's NPI number?

The NPI number for Nicole Pettibone is 1679969752. It was assigned to this individual provider in the NPPES registry on April 15, 2015.

Where is Nicole Pettibone located?

Nicole Pettibone practices at 22255 Greenfield Rd Ste 550, Southfield, MI 48075. The listed phone number is (844) 576-9226.

What is Nicole Pettibone's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Nicole Pettibone enrolled in Medicare?

Yes. Nicole Pettibone 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 Nicole Pettibone accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community, Oscar Insurance Company and Priority Health and 2 other insurers list Nicole Pettibone 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 Nicole Pettibone was last updated on January 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.