Healthcare Provider Details

I. General information

NPI: 1689226193
Provider Name (Legal Business Name): JOSHUA TIKKA LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: THALIA TIKKA LCSW

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 HULL TER
EVANSTON IL
60202-3202
US

IV. Provider business mailing address

6120 N WOLCOTT AVE
CHICAGO IL
60660-2324
US

V. Phone/Fax

Practice location:
  • Phone: 773-620-0663
  • Fax:
Mailing address:
  • Phone: 773-620-0663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: