NICOLE MEDINA LCSW
NPI 1871363820
Social Worker - Clinical in Van Buren, AR

Q: What is Nicole Medina's NPI number?

The NPI number for Nicole Medina is 1871363820. It was assigned to this individual provider in the NPPES registry on January 2, 2024.

Q: What is Nicole Medina's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nicole Medina was last updated on November 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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 January 02, 2024PECOS Enrolled

2705 OAK LN, VAN BUREN, AR 72956(479) 471-5950(479) 471-5997 Get Directions Write a Review

NPPES record last updated: November 5, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 5, 2025, Jan 2, 2024 (2 updates tracked since 2024).

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About Nicole Medina Lcsw NPPES

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

NICOLE MEDINA LCSW (NPI 1871363820) is an individual clinical provider in Van Buren, Arkansas, licensed in Arkansas (12122C) and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Fort Smith, and is a graduate of University Of Oklahoma College Of Medicine (2022).

NPPES Registry Identity

NPI1871363820

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameNICOLE MEDINACredential: LCSW

Location Address2705 OAK LNVan Buren, AR 72956-4816

Mailing AddressPo Box 11818Fort Smith, AR 72917-1818 · (479) 452-6650 · Fax (479) 452-5847

Phone(479) 471-5950

Fax(479) 471-5997

Sole ProprietorNo

Medical School CMSUniversity Of Oklahoma College Of MedicineGraduated 2022

Enumeration DateJanuary 2, 2024

Last NPPES UpdateNovember 5, 20252 updates tracked since enumeration

NPPES CertifiedNovember 5, 2025

✔ NPI 1871363820 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 AR · 12122C

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.

2705 OAK LN, Van Buren, AR 72956

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Secondary Practice Location 1

Location 13111 S 70th StFort Smith, AR 72903-5017 · Phone (479) 452-6650 · Fax (479) 452-5847

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Medina Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3870087299

PECOS Enrollment IDI20251212002590

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 72956 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 $51.36 – $157.74

Typical copayment $0.00 (range $12.84 – $39.43)

Most-billed visit code NA

Established Patient

$64.56 typical visit price

range $16.16 – $128.77

Typical copayment $16.14 (range $4.04 – $32.19)

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 8

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

THE GUIDANCE CENTER- CRAWFORD COUNTY SATS

Community/Behavioral Health