MEDICARE: NIKKI DEAR, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1134897291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NIKKI DEAR, PLLC

Provider Business Mailing Address
First Line	:	5150 TRAIL LAKE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-2030
Country	:	US
Telephone Number	:	817-380-8115
Fax Number	:

Provider Business Practice Location Address
First Line	:	5150 TRAIL LAKE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-2030
Country	:	US
Telephone Number	:	251-458-6546
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST/OWNER
Name	:	NIKKI ROSONET
Credential	:	LCSW
Telephone Number	:	817-380-8115

Provider Enumeration Date	:	09/02/2021
Last Update Date	:	04/03/2025

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