Provider Demographics
NPI:1508917196
Name:KAI, NICOLE R (MSED)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:R
Last Name:KAI
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:R
Other - Last Name:AERNIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSED
Mailing Address - Street 1:5423 S 32ND ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-1627
Mailing Address - Country:US
Mailing Address - Phone:402-613-8325
Mailing Address - Fax:
Practice Address - Street 1:5561 S 48TH ST
Practice Address - Street 2:STE 232E
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-4109
Practice Address - Country:US
Practice Address - Phone:402-613-8325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2180101Y00000X
NE1226101Y00000X
NE19101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor