Individual provider · Type 1 NPI

Blake Baker Nicholson Iii, LCSW

Clinical Social Worker · Greeley, CO

NPI number 1891769261 Active

Practice location

928 12th St
Greeley, CO 80631-4024

Call (970) 336-4910 Map

Fax (970) 336-5000

Mailing address

590 Far View Ln
Estes Park, CO 80517-9049

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X992906 (CO)

Clinical Social Worker: 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 interpers…

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About NPI 1891769261

Blake Baker Nicholson Iii, LCSW's National Provider Identifier is 1891769261, issued on Feb 14, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Greeley, CO. The record was last updated on Jul 13, 2026.