Healthcare Provider Details

I. General information

NPI: 1851102750
Provider Name (Legal Business Name): NIKKI GOINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14499 N DALE MABRY HWY STE 164
TAMPA FL
33618-2049
US

IV. Provider business mailing address

6200 OVERTON RIDGE BLVD
FORT WORTH TX
76132-3614
US

V. Phone/Fax

Practice location:
  • Phone: 813-616-2846
  • Fax: 813-804-3276
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number106984
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2026-0958
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number24765
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: