Provider Demographics
NPI:1215642319
Name:HAKIM, NICHOLAI (AMFT)
Entity type:Individual
Prefix:
First Name:NICHOLAI
Middle Name:
Last Name:HAKIM
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13700 TAHITI WAY APT 253
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6585
Mailing Address - Country:US
Mailing Address - Phone:310-717-8856
Mailing Address - Fax:
Practice Address - Street 1:12301 WILSHIRE BLVD STE 206
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1000
Practice Address - Country:US
Practice Address - Phone:310-294-9030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)