Provider Demographics
NPI:1518208404
Name:LARKIN, NICHOLAS (LCPC, LMHC, RN)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:
Last Name:LARKIN
Suffix:
Gender:M
Credentials:LCPC, LMHC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SAUNDERS RD STE 150
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-2526
Mailing Address - Country:US
Mailing Address - Phone:617-650-0785
Mailing Address - Fax:
Practice Address - Street 1:100 SAUNDERS RD STE 150
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-2526
Practice Address - Country:US
Practice Address - Phone:617-650-0785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-03
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL37590101YA0400X
FLMH17097101YM0800X
FLRN9485610163W00000X
IL180.014245101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No163W00000XNursing Service ProvidersRegistered Nurse