Provider Demographics
NPI:1730757972
Name:NOTHERN, ARIEL LAUREN
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:LAUREN
Last Name:NOTHERN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 CLIFF DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:KS
Mailing Address - Zip Code:67010-1338
Mailing Address - Country:US
Mailing Address - Phone:785-820-0583
Mailing Address - Fax:
Practice Address - Street 1:6331 W 110TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1509
Practice Address - Country:US
Practice Address - Phone:913-696-1911
Practice Address - Fax:913-696-1619
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC03814101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional