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

Mrs. Kimberly Ruth Nicolson, DSW, LCSW

Individual provider Mental Health Counselor · NPI 1164617015

Mrs. Kimberly Ruth Nicolson, DSW, LCSW is a Clinical Social Worker in Redondo Beach, California. Qualified in 2008, 18 years ago. Accepts Medicare assignment. Licensed in California.

Years since qualifying
18
Licensed in
CA
In the registry since
2007
Specialties on file
2
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

1840 S Elena Ave Ste 106
Redondo Beach, CA 90277-5716
Phone: (310) 737-2210
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X
Mental Health Counselor Taxonomy 101YM0800X · Licence 62673 (CA)

Record details

NPI number1164617015
Entity typeIndividual (Type 1)
GenderFemale
Credentials DSW , LCSW
Sole proprietorNo
NPI enumeratedSeptember 12, 2007
Last updated in NPPESDecember 26, 2024
Certification dateDecember 26, 2024

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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