DR. ANASTACIA A. NICHOLS (NPI# 1174185763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174185763 |
| Entity Type | Individual |
| Full Name | DR. ANASTACIA A. NICHOLS |
| Credential | PSYD |
| Practice Address |
12 Executive Park Dr Ne Atlanta GA 30329-2206 |
| Mailing Address |
1441 Clifton Rd Ne Ste 170 Atlanta GA 30322-1004 |
| Practice Telephone | 4047125667 |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2019-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PSY004308 | GA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1441 Clifton Rd Ne, Atlanta, GA 303221004 | 4047125667 |
| Street Address |
12 EXECUTIVE PARK DR NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30329-2206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053379669 | Peter Ash | Psychiatry & Neurology | 12 Executive Park Dr Ne, Child Psychiatry, Suite 200, Atlanta, GA 30329-2206 | 2006-05-03 |
| 1114546017 | Joya N Hampton-anderson | Psychologist | 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 | 2020-04-10 |
| 1922627116 | Justin Trop | Psychiatry & Neurology | 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 | 2020-04-09 |
| 1043852460 | Megan Leigh Goodlin | Social Worker | 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 | 2019-10-17 |
| 1134772056 | Kathleen Dickens Colsson | Nurse Practitioner | 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 | 2019-07-19 |
| 1053975268 | Kelsey R Sprang Jones | Psychologist | 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 | 2019-04-24 |
| 1114581436 | Danielle Nichole Wray | Social Worker | 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 | 2019-04-23 |
| 1326500356 | Philip Thomas Bowers | Student in an Organized Health Care Education/Training Program | 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 | 2019-03-31 |
| 1740749209 | Mary Coyle | Nurse Practitioner | 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 | 2019-03-14 |
| 1316403264 | Ashley Elizabeth Lyons | Occupational Therapist | 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 | 2019-02-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871084111 | Inner Peace Counseling Services,llc | Counselor | 2801 Bufford Highway, Suite T-10, Atlanta, GA 30329 | 2018-05-22 |
| 1912409392 | Joie De Vivre Counseling and Therapy | Counselor | 2801 Buford Highway, Ne, Atlanta, GA 30329 | 2018-03-01 |
| 1902329105 | Barbara Dunbar | Psychologist | 1777 Northeast Expressway, #175, Atlanta, GA 30329 | 2017-07-19 |
| 1114449048 | Cricket Cheyenne Gullickson | Student in an Organized Health Care Education/Training Program | 1371 Briarvista Way Ne, Atlanta, GA 30329 | 2017-07-12 |
| 1902357866 | Carla Zimmerly | Nurse Practitioner | 1711 Tullie Circle, Atlanta, GA 30329 | 2016-10-17 |
| 1316490808 | Shahzad Ghori | Student in an Organized Health Care Education/Training Program | 1727 Druid Oaks Ne, Atlanta, GA 30329 | 2016-08-01 |
| 1023467768 | Ashley Elliott | Physician Assistant | 59 Executive Park, Atlanta, GA 30329 | 2016-06-03 |
| 1285096115 | Kimberley Fox | Internal Medicine | 1600 Clifton Rd Ne, Ms A-04, Cdc, Atlanta, GA 30329 | 2016-03-21 |
| 1275991648 | Mary Patricia Joyce | Internal Medicine | 1600 Clifton Road, E-47, Centers for Disease Control and Prevention, Atlanta, GA 30329 | 2016-02-01 |
| 1346656618 | Amelia Muniz Hernandez | Pediatrics | 1841 Clifton Rd Ne # 508, Atlanta, GA 30329 | 2014-07-08 |
| Find all providers in zip 30329 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720614746 | Neuropsychology Associates of Georgia LLC | Clinical Neuropsychologist | 280 Interstate North Cir Se Ste 450, Atlanta, GA 30339-2451 | 2020-03-21 |
| 1023586773 | The Atlanta Psychology Group | Clinical Neuropsychologist | 3500 Piedmont Rd Ne Ste 740, Atlanta, GA 30305-1507 | 2018-11-09 |
| 1053850172 | S. Marilyn Miller | Clinical Neuropsychologist | 90 Fairlie St Nw, Suite 203, Atlanta, GA 30303-2127 | 2017-02-22 |
| 1457898371 | Tamara Weiss, M.d., LLC | Clinical Neuropsychologist | 1772 Century Blvd Ne Ste A, Atlanta, GA 30345-3396 | 2017-01-30 |
| 1689048076 | Laura Blackwell | Clinical Neuropsychologist | 5455 Meridian Marks Rd Ste 180, Atlanta, GA 30342-4716 | 2015-11-23 |
| 1306287412 | Negar Fani | Clinical Neuropsychologist | 101 Woodruff Cir Ste 4304, Atlanta, GA 30322-0001 | 2013-07-17 |
| 1629383799 | Aimilia Papazoglou | Clinical Neuropsychologist | 5825 Glenridge Dr Ste 1-133, Atlanta, GA 30328-7144 | 2010-08-13 |
| 1700113883 | Laura Lee Hoskins | Clinical Neuropsychologist | 2020 Peachtree Nw Rd, Atlanta, GA 30309-1426 | 2009-11-10 |
| 1831329077 | Dawn Linnea Ilardi | Clinical Neuropsychologist | 5455 Meridian Marks Rd Ne Ste 180, Atlanta, GA 30342-4716 | 2009-07-22 |
| 1174707756 | Catherine Hillary Rogers | Clinical Neuropsychologist | 280 Interstate North Cir Se, Suite 450, Atlanta, GA 30339-2450 | 2007-12-19 |
| Find all providers in ATLANTA | ||||
Please comment or provide details below to improve the information on DR. ANASTACIA A. NICHOLS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.