Provider Demographics
NPI:1356095426
Name:NDIKUM, INCREASE
Entity Type:Individual
Prefix:
First Name:INCREASE
Middle Name:
Last Name:NDIKUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18890 E 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-7140
Mailing Address - Country:US
Mailing Address - Phone:720-232-5956
Mailing Address - Fax:
Practice Address - Street 1:18890 E 45TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-7140
Practice Address - Country:US
Practice Address - Phone:720-232-5956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO871887116Medicaid