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

Nicolle Roth, LCSW

Individual provider Clinical Social Worker · NPI 1326845744

Nicolle Roth, LCSW is a Clinical Social Worker in Manor, Texas. Qualified in 2023, 3 years ago. Practices as a sole proprietor. Licensed in Colorado, Montana and Texas.

Years since qualifying
3
Licensed in
CO, MT, TX
In the registry since
2025
Specialties on file
3
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

13620 James Buchanan St
Manor, TX 78653-4087
Phone: (406) 471-2474
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 106181 (TX)
Clinical Social Worker Taxonomy 1041C0700X · Licence BBH-LCSW-LIC-79121 (MT)
Clinical Social Worker Taxonomy 1041C0700X · Licence CSW.09931317 (CO)

Record details

NPI number1326845744
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedFebruary 25, 2025
Last updated in NPPESApril 28, 2026
Certification dateApril 28, 2026

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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