Vicki Lynne Nordgulen, LPC
Individual provider Active NPI Professional Counselor · Ingram, TX
NPI 1336269380 · NPPES record last updated Jun 3, 2010
Key facts
- NPI
- 1336269380
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 14065 (TX)
- Practice address
- 3352 Junction Hwy
Ingram, TX 78025-3267 - Phone
- (830) 367-4848
- Fax
- (830) 367-7331
- NPI assigned
- Mar 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 14065 | TX | Yes |
Addresses
Primary practice location
3352 Junction Hwy
Ingram, TX 78025-3267
Mailing address
PO Box 569
Ingram, TX 78025-0569
Phone (830) 367-4848
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 027727901 | Medicaid | TX |
Other providers in Ingram, TX
- Helping Hands of Mother Teresa
- Ingram Independent School District
- Erin Nicole Ingram
- Amy F Keen
- Susannah Martha Mitchell
- Harlan Lary Priour
- Krystle M Ramsay
- Michael L Ray
- Recovery Medicine, PLLC
- Kathleen Saunders Vlasek
All providers in Ingram, TX · Professional Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.