Provider Demographics
NPI:1609248848
Name:EHLTS, NIKITA (LMHC, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:NIKITA
Middle Name:
Last Name:EHLTS
Suffix:
Gender:F
Credentials:LMHC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 31ST ST NE STE C
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-4056
Mailing Address - Country:US
Mailing Address - Phone:319-448-3481
Mailing Address - Fax:
Practice Address - Street 1:1435 31ST ST NE STE C
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-4056
Practice Address - Country:US
Practice Address - Phone:319-448-3481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014041465101Y00000X
IA088381101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0410776Medicaid
MO1609248848Medicaid