Nicole Domine, LICSW - Clinical Social Worker in Fargo, ND

Nicole Domine, LICSW is a Social Worker - Clinical based in Fargo, North Dakota. Nicole Domine is licensed to practice in North Dakota (license number 5293) and her current practice location is 4357 13th Ave S Ste 104, Fargo, North Dakota. She can be reached at her office (for appointments etc.) via phone at (701) 478-4480.

NPI number for Nicole Domine is 1396280954 and her current mailing address is 4357 13th Ave S Ste 104, Fargo, North Dakota. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1396280954.

Contact Information

Nicole Domine, LICSW
4357 13th Ave S Ste 104,
Fargo, ND 58103-7504
(701) 478-4480
(701) 478-4481



Healthcare Provider's Profile

Full NameNicole Domine
GenderFemale
SpecialitySocial Worker - Clinical
Location4357 13th Ave S Ste 104, Fargo, North Dakota
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1396280954
  • Provider Enumeration Date: 01/05/2017
  • Last Update Date: 07/21/2022

Medical Identifiers

Medical identifiers for Nicole Domine such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1396280954NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical 23025 (Minnesota)Secondary
1041C0700XSocial Worker - Clinical 5293 (North Dakota)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole Domine is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Nicole Domine, LICSW
4357 13th Ave S Ste 104,
Fargo, ND 58103-7504

Ph: (701) 478-4480
Nicole Domine, LICSW
4357 13th Ave S Ste 104,
Fargo, ND 58103-7504

Ph: (701) 478-4480

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› Verified 9 days ago


Social Worker in Fargo, ND

Rachel Marsolek, LICSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 721 1st Ave N, Fargo, ND 58102
Phone: 701-461-7364    
Brittany Joy Alexander,
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 2101 Elm St N, Fargo, ND 58102
Phone: 701-232-3241    
Tracy E Mohn, LCSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 100 4th St S, Fargo, ND 58103
Phone: 701-234-3106    Fax: 701-234-3106
Rachel Salquist, LCSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 2101 Elm St N, Fargo, ND 58102
Phone: 701-232-3241    
Tracy M Foldesi-penas, MSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 100 4th St S, Fargo, ND 58103
Phone: 701-234-3100    Fax: 701-234-3120
Lindsey Leigh Krueger, LCSW
Clinical Social Worker
Medicare: Accepting Medicare Assignments
Practice Location: 6046 14th St S, Fargo, ND 58104
Phone: 701-404-0997    Fax: 701-566-8876
Deonne J Varriano, LICSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 2624 9th Ave S, Fargo, ND 58103
Phone: 701-298-4500    Fax: 701-298-4400

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