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Individual

MR. ANTHONY J. NIKSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICDC-CS, PC-CR

Contact information

Practice address
9083 MENTOR AVE, MENTOR, OH 44060-6462
(440) 255-0678
(440) 255-6348
Mailing address
9083 MENTOR AVE, MENTOR, OH 44060-6462
(440) 255-0678
(440) 255-6348

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
913016
OH
101YP2500X
Professional Counselor
C 1100150
OH

Other

Enumeration date
07/13/2012
Last updated
03/25/2014
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