| Nichols Counseling Services Llc | |
|
5300 Brickleberry Way Ste 206 Douglasville GA 30134-4068 | |
| (678) 886-0999 | |
| (770) 485-1821 |
| Full Name | Nichols Counseling Services Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5300 Brickleberry Way Ste 206, Douglasville, Georgia |
| Authorized Official Name and Position | Tracy Nichols (OWNER) |
| Authorized Official Contact | 6788860999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nichols Counseling Services Llc 5300 Brickleberry Way Ste 206 Douglasville GA 30134-4068 Ph: (678) 886-0999 | Nichols Counseling Services Llc 5300 Brickleberry Way Ste 206 Douglasville GA 30134-4068 Ph: (678) 886-0999 |
| NPI Number | 1467037689 |
|---|---|
| Provider Enumeration Date | 03/10/2021 |
| Last Update Date | 03/10/2021 |
| Certification Date | 03/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467037689 | NPI | - | NPPES |
| 003239367A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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