Provider Demographics
NPI:1588182752
Name:KARL NITZ COUNSELING AND MENTAL TOUGHNESS TRAINING
Entity Type:Organization
Organization Name:KARL NITZ COUNSELING AND MENTAL TOUGHNESS TRAINING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:NITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:785-829-3154
Mailing Address - Street 1:549 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4120
Mailing Address - Country:US
Mailing Address - Phone:785-829-3154
Mailing Address - Fax:
Practice Address - Street 1:1700 E IRON AVE
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3401
Practice Address - Country:US
Practice Address - Phone:785-829-3154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-07
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS25281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1041CO700XMedicaid