Nikol Averbuch, LPC, LPT

Individual provider Active NPI Professional Counselor · Kansas City, MO

NPI 1508917097 · NPPES record last updated Feb 27, 2015

Key facts

NPI
1508917097
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
2008011716 (MO)
Practice address
4104 Central St
Kansas City, MO 64111-2307
Phone
(816) 974-7210
NPI assigned
Jan 13, 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

State licenses

LicenseStateTypeSpecialty
2008011716MOMDProfessional Counselor
2002020507MOMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2002020507 MO
Professional Counselor 101YP2500X 2008011716 MO Yes

Addresses

Primary practice location

4104 Central St
Kansas City, MO 64111-2307

Mailing address

4104 Central St
Kansas City, MO 64111-2307
Phone (816) 974-7210

Other providers in Kansas City, MO

All providers in Kansas City, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.