Provider Demographics
NPI:1316576671
Name:NIKAS, KONIA (LPC & LISAC)
Entity Type:Individual
Prefix:
First Name:KONIA
Middle Name:
Last Name:NIKAS
Suffix:
Gender:F
Credentials:LPC & LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2177 S MCQUEEN RD APT 2051
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-1842
Mailing Address - Country:US
Mailing Address - Phone:602-469-2185
Mailing Address - Fax:
Practice Address - Street 1:2177 S MCQUEEN RD APT 2051
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-1842
Practice Address - Country:US
Practice Address - Phone:602-469-2185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2292101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional