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

Individual provider Clinical Social Worker · NPI 1528606936

Nicole Lee McMullin, LCSW is a Clinical Social Worker in Portland, Oregon. Qualified in 2005, 21 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
21
Licensed in
OR
In the registry since
2019
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

4805 NE Glisan St
Portland, OR 97213-2933
Phone: (503) 545-9569
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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 L11641 (OR)

Record details

NPI number1528606936
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedDecember 16, 2019
Last updated in NPPESJanuary 21, 2026
Certification dateJanuary 21, 2026

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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