Provider Demographics
NPI:1265086235
Name:JENNIFER NOFIRE LLC
Entity type:Organization
Organization Name:JENNIFER NOFIRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:NOFIRE
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:316-619-4689
Mailing Address - Street 1:1221 N HOPPER DR
Mailing Address - Street 2:
Mailing Address - City:GODDARD
Mailing Address - State:KS
Mailing Address - Zip Code:67052-8856
Mailing Address - Country:US
Mailing Address - Phone:316-619-4689
Mailing Address - Fax:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty