Healthcare Provider Details

I. General information

NPI: 1831956002
Provider Name (Legal Business Name): OLIVIA E NIESEN PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLIVIA E MOERSCHEL

II. Dates (important events)

Enumeration Date: 03/04/2024
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4231 S HOCKER DR
INDEPENDENCE MO
64055-4723
US

IV. Provider business mailing address

PO BOX 844715
KANSAS CITY MO
64184-4715
US

V. Phone/Fax

Practice location:
  • Phone: 816-254-3652
  • Fax: 816-350-3103
Mailing address:
  • Phone: 417-761-5214
  • Fax: 417-761-5065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2024003551
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: