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General NPI Number Information
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NPI Number | 1144794363
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Entity Type | Organization
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Legal Business Name | NIKKI GREEN COUNSELING
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 01/22/2019
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Provider Practice Location Address
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Address Line | 7927 FLOYD ST
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City | OVERLAND PARK
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State | KS
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Zip | 66204-3724
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Country | US
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Telephone | 913-302-8450
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Fax |
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Provider Business Mailing Address
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Address Line | 7927 FLOYD ST
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City | OVERLAND PARK
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State | KS
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Zip | 66204-3724
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Country | US
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Telephone | 913-302-8450
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLETTE GREEN
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Credential | LSCSW, LCAC
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Telephone | 913-302-8450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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