Provider Demographics
NPI:1346671252
Name:JOVICILO, NIKKI M (LCPC)
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:M
Last Name:JOVICILO
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:NIKKI
Other - Middle Name:M
Other - Last Name:LANCASTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:5350 W CARMEN AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2224
Mailing Address - Country:US
Mailing Address - Phone:773-492-0913
Mailing Address - Fax:708-249-0613
Practice Address - Street 1:4849 N MILWAUKEE AVE STE 503
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2191
Practice Address - Country:US
Practice Address - Phone:773-492-0913
Practice Address - Fax:708-249-0613
Is Sole Proprietor?:No
Enumeration Date:2013-12-02
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.010117101Y00000X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional