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Adam L Nickell

Social Worker

Behavioral Health & Social Service Providers

3270 E 17th St # 131, Ammon, ID 83406-6758

PECOS Enrollment

This provider is enrolled in PECOS as ADAM NICKELL.

Based on the most recent information from CMS, provider Adam L Nickell is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1497164347
Provider Type
Individual
Full Name
Nickell, Adam L
Title
Mr.
Credential
LCSW

Gender
Male
Sole Proprietor
Yes
Enumeration Date
8/5/2014
Last Updated
3/17/2025

Contact Information

Practice Location

3270 E 17th St # 131, Ammon, ID 83406-6758

(208) 534-6568

Unlisted Fax

Mailing Location

3270 E 17th St # 131, Ammon, ID 83406-6758

(208) 534-6568

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License LCSW- 36181 Idaho
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License 14206814-3501 Utah
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License LCSW-36181 Idaho
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License 14206814-3501 Utah

Adam L Nickell

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

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