Provider Demographics
NPI:1992473490
Name:NOVICKAS, ROBERT JAMES (LMFT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JAMES
Last Name:NOVICKAS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2458 SLEEPY HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4711
Mailing Address - Country:US
Mailing Address - Phone:323-230-3315
Mailing Address - Fax:
Practice Address - Street 1:1555 W SUNSET BLVD UNIT C
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-3333
Practice Address - Country:US
Practice Address - Phone:323-230-3315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTPMF344106H00000X
TX204172106H00000X
CA126480106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist