Healthcare Provider Details

I. General information

NPI: 1790642130
Provider Name (Legal Business Name): NICOLE EFFLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 COUNTY ROAD 341
WESTCLIFFE CO
81252-9702
US

IV. Provider business mailing address

329 COUNTY ROAD 341
WESTCLIFFE CO
81252-9702
US

V. Phone/Fax

Practice location:
  • Phone: 402-416-1938
  • Fax:
Mailing address:
  • Phone: 402-416-1938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberADCC.0000690
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: