Organization
A SPACE FOR NICHOLAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAKENA STEWART MSW (OWNER)
(919) 228-8026
Entity
Organization
Contact information
Practice address
2310 S MIAMI BLVD STE 141, DURHAM, NC 27703-4900
(919) 228-8026
Mailing address
6409 FAYETTEVILLE RD STE 120 #185, DURHAM, NC 27713
(919) 228-8026
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
208000000X
Pediatrics Physician
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Enumeration date
11/21/2024
Last updated
01/26/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up