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General NPI Number Information
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NPI Number | 1952943359
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Entity Type | Individual
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Provider Name | NIKITA-CHARISMA JANELLE NICHOLAS LMHC, LPC, CAP
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Gender | Female
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Dates
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Enumeration Date | 10/17/2019
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 1601 N PALM AVE STE 211
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-3204
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Country | US
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Telephone | 954-447-0010
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Fax | 954-447-0899
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Provider Business Mailing Address
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Address Line | 1065 NE 125TH STREET SUITE 300
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5833
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Country | US
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Telephone | 888-852-6672
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Fax | 305-891-4228
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | TX
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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 | MH16832
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License Number State | FL
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