Provider Demographics
NPI:1982217188
Name:ROBINSON, NIKITA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:NIKITA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:NIKITA
Other - Middle Name:
Other - Last Name:DOOMEES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108B NATURE WAY
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-0501
Mailing Address - Country:US
Mailing Address - Phone:912-256-2492
Mailing Address - Fax:
Practice Address - Street 1:108B NATURE WAY
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-0501
Practice Address - Country:US
Practice Address - Phone:912-256-2492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA010217101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional