Provider Demographics
NPI:1104488790
Name:ESSEX, NIKITA (MSW, LICSW, LMSW)
Entity type:Individual
Prefix:
First Name:NIKITA
Middle Name:
Last Name:ESSEX
Suffix:
Gender:F
Credentials:MSW, LICSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 CALLA ST # 2
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-1427
Mailing Address - Country:US
Mailing Address - Phone:617-468-0615
Mailing Address - Fax:
Practice Address - Street 1:107 CALLA ST # 2
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-1427
Practice Address - Country:US
Practice Address - Phone:617-468-0615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-03
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health