Provider Demographics
NPI:1255605564
Name:GLIKOS, NICHOLAS (LMHC)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:
Last Name:GLIKOS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8775 202ND STREET
Mailing Address - Street 2:APT. 2
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-1656
Mailing Address - Country:US
Mailing Address - Phone:631-942-8022
Mailing Address - Fax:
Practice Address - Street 1:8775 202ND STREET
Practice Address - Street 2:APT. 2
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-1656
Practice Address - Country:US
Practice Address - Phone:631-942-8022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32782101YA0400X
NY005598101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)