| Niki Therapy Inc | |
|
1416 Park Ave Ste 201 Fernandina Beach FL 32034-1901 | |
| (904) 548-6352 | |
| Not Available |
| Full Name | Niki Therapy Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1416 Park Ave Ste 201, Fernandina Beach, Florida |
| Authorized Official Name and Position | Elizabeth Roberts (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 3212478334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Niki Therapy Inc 85074 Majestic Walk Blvd Fernandina Beach FL 32034-3872 Ph: (904) 548-6352 | Niki Therapy Inc 1416 Park Ave Ste 201 Fernandina Beach FL 32034-1901 Ph: (904) 548-6352 |
| NPI Number | 1528731817 |
|---|---|
| Provider Enumeration Date | 08/01/2021 |
| Last Update Date | 08/01/2021 |
| Certification Date | 08/01/2021 |
| Medicare PECOS PAC ID | 6305294331 |
|---|---|
| Medicare Enrollment ID | O20231130002642 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528731817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Nicole Boyce |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629589437 PECOS PAC ID: 7113375148 Enrollment ID: I20231130003735 |
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