Healthcare Provider Details

I. General information

NPI: 1790323392
Provider Name (Legal Business Name): CHRIS NIKEL JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2019
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14301 E HAMPDEN AVE
AURORA CO
80014-3902
US

IV. Provider business mailing address

1290 CHAMBERS RD
AURORA CO
80011-7117
US

V. Phone/Fax

Practice location:
  • Phone: 918-812-2738
  • Fax:
Mailing address:
  • Phone: 918-812-2738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACA0008367
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: