Provider Demographics
NPI:1326396128
Name:NICHOLS, CHRISTINE (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4870 GLENWOOD ST
Mailing Address - Street 2:APT 15
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-1469
Mailing Address - Country:US
Mailing Address - Phone:785-393-3210
Mailing Address - Fax:
Practice Address - Street 1:1301 N 47TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-1705
Practice Address - Country:US
Practice Address - Phone:913-328-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2410101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional