Healthcare Provider Details

I. General information

NPI: 1669959136
Provider Name (Legal Business Name): MAKIRA S NOLEN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 COIT RD STE 210
PLANO TX
75075-5025
US

IV. Provider business mailing address

1708 COIT RD STE 210
PLANO TX
75075-5025
US

V. Phone/Fax

Practice location:
  • Phone: 224-278-9542
  • Fax:
Mailing address:
  • Phone: 224-278-9542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number91379
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: