Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Nicholas Kim Ganoudis, LCSW-R, LP

Individual provider Clinical Social Worker · NPI 1144438045

Mr. Nicholas Kim Ganoudis, LCSW-R, LP is a Clinical Social Worker in New York, New York. Qualified in 1996, 30 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
30
Licensed in
NY
In the registry since
2007
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Practice location Address checks out

415 W 23rd St Apt 1EE
New York, NY 10011-1409
Phone: (718) 530-4446
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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 73 075665 (NY)

Record details

NPI number1144438045
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW-R , LP
Sole proprietorYes
NPI enumeratedMay 21, 2007
Last updated in NPPESFebruary 10, 2020
Certification dateFebruary 10, 2020

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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