Provider Demographics
NPI:1316035892
Name:CARLI, NIKE F (LCSWR)
Entity Type:Individual
Prefix:MS
First Name:NIKE
Middle Name:F
Last Name:CARLI
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5500 MAIN STREET
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4438
Mailing Address - Country:US
Mailing Address - Phone:716-633-6900
Mailing Address - Fax:716-633-6902
Practice Address - Street 1:5500 MAIN STREET
Practice Address - Street 2:SUITE 207
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-4438
Practice Address - Country:US
Practice Address - Phone:716-633-6900
Practice Address - Fax:716-633-6902
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYR036386-11041C0700X
R0363861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1963804Medicaid