Provider Demographics
NPI:1730068180
Name:VESCIO, NIKI MARIE (LMHC)
Entity type:Individual
Prefix:
First Name:NIKI
Middle Name:MARIE
Last Name:VESCIO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:NIKI
Other - Middle Name:MARIE
Other - Last Name:PELLICCIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:43 FLINTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-2805
Mailing Address - Country:US
Mailing Address - Phone:631-365-9398
Mailing Address - Fax:
Practice Address - Street 1:43 FLINTRIDGE DR
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-2805
Practice Address - Country:US
Practice Address - Phone:631-365-9398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011167101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health