NICOLE M. PETTIBONE LMSW
NPI 1679969752
Social Worker in Southfield, MI
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
Specialties & Licenses 2
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
6Medicare enrollment records show Nicole Pettibone reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Warren, MI 48092
- Reassigned Medicare billing, Michigan enrollment
- Medicare enrollment name: Michigan Healthcare Professionals PC
- 741 clinicians in this Medicare group
Clinton Township, MI 48036
- Reassigned Medicare billing, Michigan enrollment
- 98 clinicians in this Medicare group
Clinton Township, MI 48038
- Reassigned Medicare billing, Michigan enrollment
- 111 clinicians in this Medicare group
Southgate, MI 48195
- Reassigned Medicare billing, Michigan enrollment
- 86 clinicians in this Medicare group
Clarkston, MI 48346
- Reassigned Medicare billing, Michigan enrollment
- Medicare enrollment name: Richard Kneip Phd PC
- 347 clinicians in this Medicare group
Miami, FL 33130
- Reassigned Medicare billing, Michigan enrollment
- 411 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Which organizations bill Medicare for Nicole Pettibone's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Pettibone reassigns Medicare benefits to 6 organizations: Michigan Healthcare Professionals, P.C. (Warren, MI), Henry Ford Health Eastwood Behavioral Health (Clinton Township, MI), Seton Health Corporation Of Southeastern Michigan (Clinton Township, MI), The Guidance Center (Southgate, MI), Richard Kneip, Ph.D., P.C. (Clarkston, MI) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Pettibone's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Nicole Pettibone accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company, Priority Health and UnitedHealthcare 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.
# Nicole M. Pettibone, LMSW · NPI 1679969752
Social Worker provider in Southfield, Michigan. Individual provider, active in the CMS NPPES registry since April 15, 2015.
## Identity
- **NPI:** 1679969752 (Entity type: Individual)
- **Enumerated:** April 15, 2015
- **Primary specialty:** Social Worker · taxonomy 104100000X
- **State license:** 6801097713 (Michigan)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 22255 GREENFIELD RD STE 550, Southfield, MI 48075-3730
- **Phone:** (844) 576-9226
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 6 organizations under Medicare reassignment (form CMS-855R): Michigan Healthcare Professionals, P.C. (NPI 1568285872, Warren, MI); Henry Ford Health Eastwood Behavioral Health (NPI 1396787701, Clinton Township, MI); Seton Health Corporation Of Southeastern Michigan (NPI 1598177065, Clinton Township, MI); The Guidance Center (NPI 1609947027, Southgate, MI); Richard Kneip, Ph.D., P.C. (NPI 1679739700, Clarkston, MI); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** January 20, 2020
- **Other identifiers:** Other 6801097713 (MI)
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Source: [NPI Profile](https://npiprofile.com/npi/1679969752) · Data from the CMS NPPES public registry.