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NPI Code Detail

MEDICARE: PETER NINEMIRE COUNSELING

MEDICARE: PETER NINEMIRE COUNSELING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor344KS
21041C0700XClinical Social Worker6503KS

General Provider Information

NPI Number : 1548526296
Entity Type Code : Organization
Provider Name (Legal Business Name) : PETER NINEMIRE COUNSELING
Provider Business Mailing Address
First Line : 714 S HILLSIDE ST
Second Line :
City : WICHITA
State : KS
Zip : 67211-3002
Country : US
Telephone Number : 316-295-4800
Fax Number :
Provider Business Practice Location Address
First Line : 714 S HILLSIDE ST
Second Line :
City : WICHITA
State : KS
Zip : 67211-3002
Country : US
Telephone Number : 316-295-4800
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MR. PETER JOSEPH NINEMIRE
Credential : LMSW, LCAC
Telephone Number : 316-295-4800
Provider Enumeration Date : 04/06/2012
Last Update Date : 04/06/2012

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Directions to “PETER NINEMIRE COUNSELING ” Practice Location

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