Provider Demographics
NPI:1871370189
Name:FELS, NICOLE (MA, NCC, PLPC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:FELS
Suffix:
Gender:F
Credentials:MA, NCC, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 MIDDLEMARCH TER
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-2961
Mailing Address - Country:US
Mailing Address - Phone:816-389-0656
Mailing Address - Fax:
Practice Address - Street 1:17 E KANSAS ST STE 200
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-2372
Practice Address - Country:US
Practice Address - Phone:816-320-5903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022049386101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health