Provider Demographics
NPI:1619349479
Name:LYKINS, JOHN (LMHC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:LYKINS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11024 MONTGOMERY BLVD NE
Mailing Address - Street 2:PMB 360
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3962
Mailing Address - Country:US
Mailing Address - Phone:505-738-3928
Mailing Address - Fax:505-738-3922
Practice Address - Street 1:707 BROADWAY BLVD NE
Practice Address - Street 2:SUITE 103
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2360
Practice Address - Country:US
Practice Address - Phone:505-933-4639
Practice Address - Fax:505-206-5680
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM0176641101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health