Provider Demographics
NPI:1194847954
Name:NIKITIN, HELEN (LCSW)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:NIKITIN
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 1:1046 W TAYLOR ST
Mailing Address - Street 2:SUITE #100
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1815
Mailing Address - Country:US
Mailing Address - Phone:408-297-7349
Mailing Address - Fax:408-297-7354
Practice Address - Street 1:1046 W TAYLOR ST
Practice Address - Street 2:SUITE #100
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1815
Practice Address - Country:US
Practice Address - Phone:408-297-7349
Practice Address - Fax:408-297-7354
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22533101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health