Healthcare Provider Details

I. General information

NPI: 1821938291
Provider Name (Legal Business Name): NICOLE ESPINOSA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 N ROCK RD BLDG 100
WICHITA KS
67226-1328
US

IV. Provider business mailing address

946 N PARKWAY DR
VALLEY CENTER KS
67147-2677
US

V. Phone/Fax

Practice location:
  • Phone: 316-710-7918
  • Fax:
Mailing address:
  • Phone: 316-990-6634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number05334
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: