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Individual

PETER J NINEMIRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LSCSW, LCAC

Contact information

Practice address
714 S HILLSIDE ST, WICHITA, KS 67211-3002
(316) 295-4800
(316) 295-4811
Mailing address
714 S HILLSIDE ST, WICHITA, KS 67211-3002
(316) 295-4800
(316) 295-4811

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
344
KS
101YA0400X
Addiction (Substance Use Disorder) Counselor
104100000X
Social Worker
6503
KS
1041C0700X
Clinical Social Worker
Primary
4326
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200570410C
KS
Enumeration date
08/29/2008
Last updated
08/12/2022
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