Provider Demographics
NPI:1760706857
Name:NOFIRE, JENNIFER RACHELLE (LSCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RACHELLE
Last Name:NOFIRE
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1883 W 21ST ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-2104
Mailing Address - Country:US
Mailing Address - Phone:316-832-0277
Mailing Address - Fax:316-838-5658
Practice Address - Street 1:920 N TYLER RD STE 104
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-3267
Practice Address - Country:US
Practice Address - Phone:316-619-4689
Practice Address - Fax:866-316-4467
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS43451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical