Provider Demographics
NPI:1518131150
Name:DIFRANKS, NIKKI NELSON (PHD LCSW)
Entity Type:Individual
Prefix:DR
First Name:NIKKI
Middle Name:NELSON
Last Name:DIFRANKS
Suffix:
Gender:F
Credentials:PHD LCSW
Other - Prefix:
Other - First Name:NIKKI
Other - Middle Name:
Other - Last Name:NELSON CRABBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:385 SOUTH END AVENUE
Mailing Address - Street 2:SUITE 7B
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10280
Mailing Address - Country:US
Mailing Address - Phone:917-860-9057
Mailing Address - Fax:212-488-9186
Practice Address - Street 1:385 SOUTH END AVENUE
Practice Address - Street 2:SUITE 7B
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10280
Practice Address - Country:US
Practice Address - Phone:917-860-9057
Practice Address - Fax:212-488-9186
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0696071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNE2921Medicare PIN