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General NPI Number Information
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NPI Number | 1639738768
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Entity Type | Individual
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Provider Name | NIKKI HENDRICKSON PCMSW, PLMHP
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Gender | Female
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 100 W NORFOLK AVE
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City | NORFOLK
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State | NE
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Zip | 68701-5340
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Country | US
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Telephone | 308-991-0873
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Fax |
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Provider Business Mailing Address
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Address Line | 1112 E MEADOW RIDGE RD
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City | NORFOLK
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State | NE
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Zip | 68701-7204
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Country | US
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Telephone | 308-991-0873
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6990
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10571
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License Number State | NE
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