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

Individual provider Clinical Social Worker · NPI 1679969752

Nicole M. Pettibone, LMSW is a Clinical Social Worker in Southfield, Michigan. Qualified in 2014, 12 years ago. Practices with Richard Kneip PHD PC, a 243-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
12
Licensed in
MI
In the registry since
2015
Specialties on file
2
What do these letters mean?
LMSW — Licensed Master Social Worker
A master's-level social worker, usually practising under supervision.

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Practice location Address checks out

22255 Greenfield Rd Ste 550
Southfield, MI 48075-3730
Phone: (844) 576-9226
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 6801097713 (MI)
Clinical Social Worker Taxonomy 1041C0700X · Licence 6801097713 (MI)

Record details

NPI number1679969752
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMSW
Sole proprietorYes
NPI enumeratedApril 15, 2015
Last updated in NPPESJanuary 20, 2020
Certification dateJanuary 20, 2020

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Richard Kneip Phd Pc — 243 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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