Provider Demographics
NPI:1013382951
Name:NICHOLS, FELICIA MARIE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:MARIE
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8433
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-0433
Mailing Address - Country:US
Mailing Address - Phone:913-800-0893
Mailing Address - Fax:913-229-7511
Practice Address - Street 1:6811 SHAWNEE MISSION PKWY STE 310
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-4088
Practice Address - Country:US
Practice Address - Phone:816-800-0893
Practice Address - Fax:913-229-7511
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2471101YM0800X
MO2015035421101YM0800X
KS2866101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health