Provider Demographics
NPI:1629725080
Name:LYKINS, CORINNE CARIDAD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CORINNE
Middle Name:CARIDAD
Last Name:LYKINS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 MARIN BLVD APT 10T
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3679
Mailing Address - Country:US
Mailing Address - Phone:505-850-6656
Mailing Address - Fax:
Practice Address - Street 1:1000 DEAN ST STE 226
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-3383
Practice Address - Country:US
Practice Address - Phone:347-669-9792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-06
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty