Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carol Nickles, LCSW

Individual provider Clinical Social Worker · NPI 1780138776

Carol Nickles, LCSW is a Clinical Social Worker in Madison, Wisconsin. Qualified in 1988, 38 years ago. Practices with Moontree Psychotherapy Center LLC, an 11-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
38
Licensed in
WI
In the registry since
2016
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

401 Wisconsin Ave
Madison, WI 53703-1487
Phone: (608) 256-5115
Fax: (608) 256-5116
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 2843-123 (WI)

Record details

NPI number1780138776
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedAugust 8, 2016
Last updated in NPPESAugust 8, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Group practice Moontree Psychotherapy Center Llc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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