Provider Demographics
NPI:1447581970
Name:NIKLA, RICHARD HARBESON (MA, LMHC, CAP, ICADC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:HARBESON
Last Name:NIKLA
Suffix:
Gender:M
Credentials:MA, LMHC, CAP, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17196
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34276-0196
Mailing Address - Country:US
Mailing Address - Phone:941-780-6939
Mailing Address - Fax:941-953-1399
Practice Address - Street 1:8225 STATE ROAD 54 STE 104
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-3016
Practice Address - Country:US
Practice Address - Phone:941-780-6939
Practice Address - Fax:941-953-1399
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9995101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health