Provider Demographics
NPI:1437382892
Name:PERRY, NIKKI M (MED, LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:M
Last Name:PERRY
Suffix:
Gender:F
Credentials:MED, LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 SPRING HILL DR
Mailing Address - Street 2:SUITE 360
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77386-6027
Mailing Address - Country:US
Mailing Address - Phone:713-677-3330
Mailing Address - Fax:
Practice Address - Street 1:504 SPRING HILL DR
Practice Address - Street 2:SUITE 360
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77386-6027
Practice Address - Country:US
Practice Address - Phone:713-677-3330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65418101YP2500X
TX10935101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)