Provider Demographics
NPI:1962101444
Name:DULA, COURTNEY NIKILA (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:NIKILA
Last Name:DULA
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:NIKI
Other - Middle Name:
Other - Last Name:DULA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:2680 E MAIN ST STE 227
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-2830
Mailing Address - Country:US
Mailing Address - Phone:765-787-1196
Mailing Address - Fax:
Practice Address - Street 1:2680 E MAIN ST STE 227
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-2830
Practice Address - Country:US
Practice Address - Phone:804-832-6389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34009897A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical