Provider Demographics
NPI:1427381474
Name:MIAN, NICHOLAS (PHD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:MIAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:648 BEACON ST
Mailing Address - Street 2:CENTER FOR ANXIETY AND RELATED DISORDERS, B.U.
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-2013
Mailing Address - Country:US
Mailing Address - Phone:617-353-9619
Mailing Address - Fax:
Practice Address - Street 1:648 BEACON ST
Practice Address - Street 2:CENTER FOR ANXIETY AND RELATED DISORDERS, B.U.
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-2013
Practice Address - Country:US
Practice Address - Phone:617-353-9610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health