Provider Demographics
NPI:1972913507
Name:WATKINS, NIKOLAS BRANDON (MA, LPCC)
Entity type:Individual
Prefix:MR
First Name:NIKOLAS
Middle Name:BRANDON
Last Name:WATKINS
Suffix:
Gender:M
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 78TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-2744
Mailing Address - Country:US
Mailing Address - Phone:763-416-9165
Mailing Address - Fax:763-416-9120
Practice Address - Street 1:7000 78TH AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-2744
Practice Address - Country:US
Practice Address - Phone:763-416-9165
Practice Address - Fax:763-416-9120
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00777101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional