Provider Demographics
NPI:1114478401
Name:GEVING, NICOL (LMHC TEMP)
Entity Type:Individual
Prefix:
First Name:NICOL
Middle Name:
Last Name:GEVING
Suffix:
Gender:F
Credentials:LMHC TEMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-3714
Mailing Address - Country:US
Mailing Address - Phone:319-240-7457
Mailing Address - Fax:
Practice Address - Street 1:1504 OLIVE ST
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-3714
Practice Address - Country:US
Practice Address - Phone:319-240-7457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA074668101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health