Provider Demographics
NPI:1942834114
Name:NGUYEN, NICOLE MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 E PRAIRIE HILL CIR
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67219-1001
Mailing Address - Country:US
Mailing Address - Phone:207-602-9662
Mailing Address - Fax:
Practice Address - Street 1:121 S WHITTIER RD STE 350
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-1064
Practice Address - Country:US
Practice Address - Phone:316-519-0485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator