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General NPI Number Information
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NPI Number | 1225418155
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Entity Type | Organization
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Legal Business Name | RICHARD NIKLA LMHC DBA WEST COAST BEHAVIORAL THERAPY
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 2100 CONSTITUTION BLVD
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City | SARASOTA
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State | FL
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Zip | 34231-4146
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Country | US
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Telephone | 941-780-6939
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Fax | 941-953-1399
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Provider Business Mailing Address
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Address Line | 5441 RIVERBLUFF CIR # V85
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City | SARASOTA
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State | FL
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Zip | 34231-5025
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Country | US
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Telephone | 941-780-6939
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Fax | 941-953-1399
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICHARD HARBESON NIKLA
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Credential | MA, LMHC, CAP, ICADC
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Telephone | 941-780-6939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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