A Space For Nicholas LLC
Community/Behavioral Health in Durham, NC. Organization (NPI-2).
NPI number1922823194
StatusActive
Last updated in NPPESJan 26, 2025
Details
- NPI
- 1922823194
- Entity type
- Organization (NPI-2)
- Legal business name
- A Space For Nicholas LLC
- Organization subpart
- No
- Enumeration date
- Nov 21, 2024
- Certification date
- Jan 26, 2025
- Last updated
- Jan 26, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 103K00000X | Behavior Analyst | – | – | |
| 104100000X | Social Worker | – | – | |
| 1041C0700X | Social Worker, Clinical | – | – | |
| 106E00000X | Assistant Behavior Analyst | – | – | |
| 106S00000X | Behavior Technician | – | – | |
| 208000000X | Pediatrics | – | – | |
| 225X00000X | Occupational Therapist | – | – | |
| 235Z00000X | Speech-Language Pathologist, | – | – | |
| 261QH0100X | Clinic/Center, Health Services | – | – |
Practice location
2310 S Miami Blvd Ste 141Durham, NC 27703-4900
Phone 919-228-8026
Mailing address
6409 Fayetteville Rd Ste 120 #185Durham, NC 27713
Phone 919-228-8026
Other practice locations
706 Carpenter Fletcher Rd
Durham, NC 27713
Durham, NC 27713
Phone 919-806-7170
Authorized official
Dakena Stewart
Owner
9192288026
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