Provider Demographics
NPI:1073856647
Name:NIKLE, ASHLEY DAWN (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DAWN
Last Name:NIKLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4023 STATE ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0690
Mailing Address - Country:US
Mailing Address - Phone:701-751-4447
Mailing Address - Fax:701-751-4471
Practice Address - Street 1:4023 STATE ST
Practice Address - Street 2:SUITE 120
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0690
Practice Address - Country:US
Practice Address - Phone:701-751-4447
Practice Address - Fax:701-751-4471
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4427104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker