Provider Demographics
NPI:1265511257
Name:LEVINE, NIKKI ANN (LCPC)
Entity Type:Individual
Prefix:MS
First Name:NIKKI
Middle Name:ANN
Last Name:LEVINE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 N MILWAUKEE AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1553
Mailing Address - Country:US
Mailing Address - Phone:847-247-9300
Mailing Address - Fax:847-247-9339
Practice Address - Street 1:850 N MILWAUKEE AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1553
Practice Address - Country:US
Practice Address - Phone:847-247-9300
Practice Address - Fax:847-247-9339
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional