Provider Demographics
NPI:1588695456
Name:DYK, NICOLE S (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:S
Last Name:DYK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 S MAIN ST
Mailing Address - Street 2:#265
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5321
Mailing Address - Country:US
Mailing Address - Phone:303-829-3668
Mailing Address - Fax:720-274-5267
Practice Address - Street 1:6240 S MAIN ST
Practice Address - Street 2:#265
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-5321
Practice Address - Country:US
Practice Address - Phone:303-829-3668
Practice Address - Fax:720-274-5267
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9927461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical