Provider Demographics
NPI:1477188225
Name:NIKULA, BRETT (MS, LAMFT)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:NIKULA
Suffix:
Gender:M
Credentials:MS, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 COTTONWOOD AVE NE
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:MN
Mailing Address - Zip Code:55376-9581
Mailing Address - Country:US
Mailing Address - Phone:763-258-4311
Mailing Address - Fax:
Practice Address - Street 1:106 CENTRAL AVE E
Practice Address - Street 2:
Practice Address - City:SAINT MICHAEL
Practice Address - State:MN
Practice Address - Zip Code:55376-9511
Practice Address - Country:US
Practice Address - Phone:763-258-4311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3980106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist