Provider Demographics
NPI:1578248605
Name:IWUAGWU, NNADOZIE (NCC, LPC, LMAC)
Entity Type:Individual
Prefix:
First Name:NNADOZIE
Middle Name:
Last Name:IWUAGWU
Suffix:
Gender:M
Credentials:NCC, LPC, LMAC
Other - Prefix:
Other - First Name:DOZIE
Other - Middle Name:
Other - Last Name:IWUAGWU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCC, LPC, LMAC
Mailing Address - Street 1:8100 E 22ND ST N STE 3
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2350
Mailing Address - Country:US
Mailing Address - Phone:916-969-3491
Mailing Address - Fax:
Practice Address - Street 1:8100 E 22ND ST N STE 3
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2350
Practice Address - Country:US
Practice Address - Phone:316-347-7157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS00955101YA0400X
KS3388101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty