Provider Demographics
NPI:1861563405
Name:NITZSCHKE, JANICE L (LCSW)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:L
Last Name:NITZSCHKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 ROCKDALE RD
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-4512
Mailing Address - Country:US
Mailing Address - Phone:918-333-4099
Mailing Address - Fax:
Practice Address - Street 1:2200 SE WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-7135
Practice Address - Country:US
Practice Address - Phone:918-335-1111
Practice Address - Fax:918-335-1119
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical