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NPI Code Detail

MEDICARE: NIKARA DURST LPC

MEDICARE: NIKARA DURST LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor178014028IL
2101YM0800XMental Health Counselor10564125WI

General Provider Information

NPI Number : 1326590241
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKARA DURST LPC
Provider Business Mailing Address
First Line : 251 PROGRESS WAY
Second Line :
City : WAUNAKEE
State : WI
Zip : 53597-2520
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 251 PROGRESS WAY STE 102
Second Line :
City : WAUNAKEE
State : WI
Zip : 53597-2520
Country : US
Telephone Number : 608-849-5430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2016
Last Update Date : 10/17/2023

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Directions to “ NIKARA DURST LPC” Practice Location

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