Provider Demographics
NPI:1609332832
Name:NANTON, NICKISHA (LCSW)
Entity Type:Individual
Prefix:
First Name:NICKISHA
Middle Name:
Last Name:NANTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 W 26TH AVE STE 200D
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5303
Mailing Address - Country:US
Mailing Address - Phone:479-502-8132
Mailing Address - Fax:
Practice Address - Street 1:2420 W 26TH AVE STE 200D
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5303
Practice Address - Country:US
Practice Address - Phone:720-200-1036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-12
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
CO1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical