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

Stefan Nickum, LICSW

Individual provider Clinical Social Worker · NPI 1518709559

Stefan Nickum, LICSW is a Clinical Social Worker in Granville, Vermont. Practices as a sole proprietor. Licensed in Vermont.

Licensed in
VT
In the registry since
2024
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

See every abbreviation used in this directory →

Practice location Address checks out

3993 Vt Route 100
Granville, VT 05747-9747
Phone: (206) 818-2439
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 089.0134493 (VT)

Record details

NPI number1518709559
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedJune 11, 2024
Last updated in NPPESJune 11, 2024
Certification dateJune 11, 2024