MEDICARE: MRS. COURTNEY MICHELLE NICKA MHR, LPC

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	103K00000X	Behavior Analyst		OK

General Provider Information

NPI Number	:	1659666501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COURTNEY MICHELLE NICKA MHR, LPC

Provider Business Mailing Address
First Line	:	1610 SOUTH ADAMS
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73701
Country	:	US
Telephone Number	:	405-714-3724
Fax Number	:

Provider Business Practice Location Address
First Line	:	1625 WEST OWEN K GARRIOTT ROAD # F
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73703
Country	:	US
Telephone Number	:	580-242-4673
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2011
Last Update Date	:	01/23/2026

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