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NICOLE RAE LIPPERT AVSHALOMOV LCSW
NPI 1922555663
Social Worker - Clinical in Hayward, CA

Active since September 09, 2016Opted out of Medicare · through Oct 19, 2026
22505 WOODROE AVE, HAYWARD, CA 94541(510) 318-6112 Get Directions Write a Review

NPPES record last updated: April 18, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nicole Rae Lippert Avshalomov Lcsw NPPES

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

NICOLE RAE LIPPERT AVSHALOMOV LCSW (NPI 1922555663) is an individual clinical provider in Hayward, California and active in the NPI registry since September 2016. She has opted out of Medicare through October 19, 2026.

NPPES Registry Identity

NPI1922555663
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameNICOLE RAE LIPPERT AVSHALOMOVCredential: LCSW
Location Address22505 WOODROE AVEHayward, CA 94541-3410
Mailing Address629 Oakland AveOakland, CA 94611-3410 · (510) 957-7651
Phone(510) 318-6112
Sole ProprietorNo
Enumeration DateSeptember 9, 2016
Last NPPES UpdateApril 18, 2024
NPPES CertifiedApril 18, 2024
✔ NPI 1922555663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
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.
22505 WOODROE AVE, Hayward, CA 94541
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Nicole Rae Lippert Avshalomov Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 19, 2020 through October 19, 2026.

Opt-Out Effective DateOctober 19, 2020
Opt-Out In Effect ThroughOctober 19, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

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

JENIFER CASTANEDA
Counselor (Mental Health)
22505 WOODROE AVE
HAYWARD, CA 94541
Alameda County (510) 537-9223
SHANICE KELLEY
Counselor (Mental Health)
22505 WOODROE AVE
HAYWARD, CA 94541
Alameda County (510) 537-1688
LLOYD H WAGNER
Counselor (Mental Health)
22505 WOODROE AVE
HAYWARD, CA 94541
Alameda County (510) 537-1688
CHANTHAL PATRICIA LASSO
Counselor (Mental Health)
22505 WOODROE AVE
HAYWARD, CA 94541
Alameda County (510) 537-1688
SOFIA SIENA VAN SICKLE
Counselor (Professional)
22505 WOODROE AVE
HAYWARD, CA 94541
Alameda County (510) 613-0330
SHYETA WILLIAMS
Marriage & Family Therapist
22505 WOODROE AVE
HAYWARD, CA 94541
Alameda County (707) 332-8096
KENNETH TANG
Counselor (Mental Health)
22505 WOODROE AVE
HAYWARD, CA 94541
Alameda County (510) 537-1688
MIGUEL ENRIQUE MONTOYA MURCIA
Counselor
22505 WOODROE AVE
HAYWARD, CA 94541
Alameda County (510) 318-6112

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 Avshalomov's NPI number?

The NPI number for Nicole Avshalomov is 1922555663. It was assigned to this individual provider in the NPPES registry on September 9, 2016.

Where is Nicole Avshalomov located?

Nicole Avshalomov practices at 22505 Woodroe Ave, Hayward, CA 94541. The listed phone number is (510) 318-6112.

What is Nicole Avshalomov's specialty?

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

Is Nicole Avshalomov enrolled in Medicare?

No. Nicole Avshalomov has opted out of Medicare through October 19, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Nicole Avshalomov was last updated on April 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.