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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

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

Active since September 09, 2016Opted out of Medicare · through Oct 19, 2026
3800 COOLIDGE AVE, OAKLAND, CA 94602(510) 482-2244 Get Directions Write a Review

NPPES record last updated: August 26, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Aug 26, 2026, Apr 18, 2024 (2 updates tracked since 2024).

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 Oakland, 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 Address3800 COOLIDGE AVEOakland, CA 94602-3399
Mailing Address1197 Ocean AveOakland, CA 94608-1147 · (818) 239-6635
Phone(510) 482-2244
Sole ProprietorNo
Enumeration DateSeptember 9, 2016
Last NPPES UpdateAugust 26, 20262 updates tracked since enumeration
NPPES CertifiedAugust 26, 2026
✔ 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.
3800 COOLIDGE AVE, Oakland, CA 94602
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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.

MARY ELLEN ROJAS
Marriage & Family Therapist
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
KAYLA JOANNE DOUGLAS
Student in an Organized Health Care Education/Training Program
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
MICHAELLA HELENA DEAN
Marriage & Family Therapist
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
FRED FINCH YOUTH & FAMILY SERVICES
Adult Companion
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
MR. ROGER WAYNE DANIELS LCSW
Social Worker (Clinical)
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
MS. ALEXIS V. LOWENSTEIN LMFT
Marriage & Family Therapist
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
KENDRA SUNYUNG STAFFORD ROBINSON LMFT
Marriage & Family Therapist
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 482-2244
MISS MARY KATHERINE COPE MFT
Counselor (Mental Health)
3800 COOLIDGE AVE
OAKLAND, CA 94602
Alameda County (510) 773-9629

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 3800 Coolidge Ave, Oakland, CA 94602. The listed phone number is (510) 482-2244.

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 August 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 days 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.