Provider Demographics
NPI:1871693903
Name:PRESLEY, NIKKI A (LCSW, LCAC)
Entity type:Individual
Prefix:MS
First Name:NIKKI
Middle Name:A
Last Name:PRESLEY
Suffix:
Gender:F
Credentials:LCSW, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4847 E. VIRGINIA SUITE D
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715
Mailing Address - Country:US
Mailing Address - Phone:812-479-1242
Mailing Address - Fax:812-479-1330
Practice Address - Street 1:4847 E. VIRGINIA SUITE D
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715
Practice Address - Country:US
Practice Address - Phone:812-479-1242
Practice Address - Fax:812-479-1330
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34001840A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000488008OtherANTHEM PIN
KY65945420OtherMEDICAID GROUP
IN237890OtherMEDICARE GROUP
IN200829650DOtherMEDICAID GROUP
KY65945420OtherMEDICAID GROUP