NICOLE MARIE LIEDTKE LCSW, LCAC
NPI 1740505460
Social Worker - Clinical in Fishers, IN

Active since April 06, 2010PECOS EnrolledAccepts Medicare Assignment
14074 TRADE CENTER DR, STE 220, FISHERS, IN 46038(317) 775-7797 Get Directions Write a Review

NPPES record last updated: December 10, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 10, 2020, Oct 6, 2020, Sep 14, 2017 (3 updates tracked since 2017).

About Nicole Marie Liedtke Lcsw, Lcac NPPES

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

NICOLE MARIE LIEDTKE LCSW, LCAC (NPI 1740505460) is an individual clinical provider in Fishers, Indiana, licensed in Indiana (34005950A) and active in the NPI registry since April 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1740505460
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameNICOLE MARIE LIEDTKECredential: LCSW, LCAC
Location Address14074 TRADE CENTER DR, STE 220Fishers, IN 46038-4575
Mailing Address3645 N Briarwood Ln, Ste AMuncie, IN 47304-5337 · (765) 289-5520 · Fax (765) 289-5840
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateApril 6, 2010
Last NPPES UpdateDecember 10, 20203 updates tracked since enumeration
NPPES CertifiedDecember 10, 2020
NPI 1740505460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in IN · 34005950A
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.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 87001005A (IN)
14074 TRADE CENTER DR, Fishers, IN 46038

Other Names 1

Former Name (1)Nicole Marie Wallace Lcsw, Lcac

Other Identifiers 2

Other000001111107IN · Anthem Blue Cross Blue Shield
Other34005950AIN · Lcsw

Accepted 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 Marie Liedtke Lcsw, Lcac 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 ID2163691817
PECOS Enrollment IDI20110815000120
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 46038 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 $53.07 – $161.76
Typical copayment $0.00 (range $13.26 – $40.44)
Most-billed visit code NA
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
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 16

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

Chiropractor
14074 TRADE CENTER DR, SUITE 136
FISHERS, IN 46038
Behavior Analyst
14074 TRADE CENTER DR, SUITE 134
FISHERS, IN 46038
Chiropractor
14074 TRADE CENTER DR
FISHERS, IN 46038
Counselor (Addiction (Substance Use Disorder))
14074 TRADE CENTER DR, SUITE 142
FISHERS, IN 46038
Homemaker
14074 TRADE CENTER DR
FISHERS, IN 46038
Clinic/Center (Physical Therapy)
14074 TRADE CENTER DR, #232
FISHERS, IN 46038
Hearing Instrument Specialist
14074 TRADE CENTER DR, SUITE 114
FISHERS, IN 46038
Nurse Practitioner
14074 TRADE CENTER DR, SUITE 136
FISHERS, IN 46038

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 Liedtke's NPI number?

The NPI number for Nicole Liedtke is 1740505460. It was assigned to this individual provider in the NPPES registry on April 6, 2010. The provider is also known as Nicole Marie Wallace Lcsw, Lcac.

Where is Nicole Liedtke located?

Nicole Liedtke practices at 14074 Trade Center Dr Ste 220, Fishers, IN 46038. The listed phone number is (317) 775-7797.

What is Nicole Liedtke's specialty?

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

Is Nicole Liedtke enrolled in Medicare?

Yes. Nicole Liedtke 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 Liedtke accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and UnitedHealthcare list Nicole Liedtke 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 Liedtke was last updated on December 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.