Provider Demographics
NPI:1568844983
Name:TERMINI, NICOLE L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:L
Last Name:TERMINI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WHITEMAN AFB
Mailing Address - Street 2:4076 PERIMETER RD; RM 131
Mailing Address - City:KNOB NOSTER
Mailing Address - State:MO
Mailing Address - Zip Code:65305-5055
Mailing Address - Country:US
Mailing Address - Phone:660-687-8110
Mailing Address - Fax:
Practice Address - Street 1:WHITEMAN AFB
Practice Address - Street 2:4076 PERIMETER RD; RM 131
Practice Address - City:KNOB NOSTER
Practice Address - State:MO
Practice Address - Zip Code:65305-5055
Practice Address - Country:US
Practice Address - Phone:660-687-8110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9596104100000X
MO20180123101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker