person
Nicole Darlene Ethridge, MA,LPC
Professional Counselor in Columbia, Missouri
NPI 1760974596

Nicole Darlene Ethridge is a Professional Counselor based in Springfield, MO and is specialized in Professional. Nicole Darlene Ethridge practices in Columbia, MO and has the professional credentials of MA,LPC. The NPI Number for Nicole Darlene Ethridge is 1760974596 and holds a License No. 2018013675 (Missouri).

The current practice location address for Nicole Darlene Ethridge is 1805 E Walnut St, Columbia, MO and can be reached out via phone at 573-777-7500 and via fax at 573-777-7505. You can also correspond with Nicole Darlene Ethridge through the mailing address at 1300 E BRADFORD PKWY, SPRINGFIELD, MO - 65804-4264 (mailing address contact number: 417-761-5000).

Location: 1805 E Walnut St, Columbia, MO, 65804-4264
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Provider Profile Details
NPI Number
1760974596
Provider Name
Nicole Darlene Ethridge
Credential
MA,LPC
Provider Entity Type
Individual
Gender
Female
Address
1805 E Walnut St, Columbia, MO, 65804-4264
Phone Number
573-777-7500
Fax Number
573-777-7505
Provider Enumeration Date
06/06/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
490055189 05 MO
institution
Provider Business Practice Location Address Details
Address
1805 E Walnut St
City
State
Zip
65201-6425
Phone Number
573-777-7500
Fax Number
573-777-7505
person
Provider Business Mailing Address Details
Address
1805 E Walnut St
City
State
Zip
65201-6425
Phone Number
573-777-7500
Fax Number
573-777-7505
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
License No.
101YP2500X (Missouri)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
2018013675 (Missouri)
Definition
Definition to come...
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