| Doctor Name: | MR. ANTHONY J. NIKSA |
| NPI Number: | 1033464201 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LICDC-CS, PC-CR |
| License Number: | C 1100150 |
| Business Practice Address: | 9083 Mentor Ave Mentor, OH - 440606462 |
| Business Phone Number: | 4402550678 |
| Business Fax Number: | 4402556348 |
| Mailing Address: | 9083 Mentor Ave, MENTOR |
| State: | OH |
| Postal Code: | 440606462 |
| Phone Number: | 4402550678 |
| Fax Number: | 4402556348 |
| NPI Enumeration Date: | 07/13/2012 |
| NPI Last Update Date: | 03/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | C 1100150 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |