Reallifedreams

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

18158 Issued in CA

Legal business name

REALLIFEDREAMS

Doing business as

Lynn L Nickens, M.S.W., LCSW

Practice address

14240 Saint Andrews Dr
Suite 101
Victorville, CA 92395-4308

Phone

(760) 927-8896

Fax

(866) 382-9020

NPI assigned

Mar 19, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Lynn Nickens, LCSW

Title

President

Phone

(760) 927-8896

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lynn L Nickens, M.S.W., LCSW Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1457626889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1554 BARTON RD # 114",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735457",
            "telephone_number": "760-927-8896",
            "fax_number": "866-382-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14240 SAINT ANDREWS DR",
            "address_2": "SUITE 101",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954308",
            "telephone_number": "760-927-8896",
            "fax_number": "866-382-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REALLIFEDREAMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "NICKENS",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-927-8896",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "18158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1114138252",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lynn L Nickens, M.S.W., LCSW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bryon Raymond
• Keith Brian Raymond, P.T.
• Razi Medical Group Inc
• Cristal Real
• Marlene Real
• Realm Transport Inc.
• Realm Transport Inc.
• Valerie Anne Hernandez Recreo
• Reda M Tadros MD Inc
• Geetha Reddy, M.D.

• Community/Behavioral Health Agency in Victorville, CA
• Providers in Victorville, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.