Provider Demographics
NPI:1750786521
Name:VOGEL, NICOLA ROSE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:NICOLA
Middle Name:ROSE
Last Name:VOGEL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:IACH
Mailing Address - Street 2:650 HUEBNER RD.
Mailing Address - City:FORT RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66442
Mailing Address - Country:US
Mailing Address - Phone:785-240-8221
Mailing Address - Fax:
Practice Address - Street 1:IACH
Practice Address - Street 2:650 HUEBNER RD.
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442
Practice Address - Country:US
Practice Address - Phone:785-240-8221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007083A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical