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

Nicole Dallas

Individual provider Clinical Social Worker · NPI 1306522578

Nicole Dallas is a Clinical Social Worker in Ghent, New York. Qualified in 2021, 5 years ago. Practices with Survivors of Abuse in Recovery Inc, a 9-clinician group and accepts Medicare assignment. Licensed in Delaware.

Years since qualifying
5
Licensed in
DE
In the registry since
2023

Practice location Address checks out

586 County Route 9
Ghent, NY 12075-2312
Phone: (518) 965-2648
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence Q1-0012293 (DE)

Record details

NPI number1306522578
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 23, 2023
Last updated in NPPESJune 23, 2023
Certification dateJune 23, 2023
Mailing address586 County Route 9, Ghent, NY 12075-2312

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Survivors Of Abuse In Recovery Inc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Ghent