DR. AMANDA NICOLE NICHOLSON (NPI# 1205451960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205451960 |
| Entity Type | Individual |
| Full Name | DR. AMANDA NICOLE NICHOLSON |
| Credential | PHD, LMFT, ME.D. |
| Practice Address |
269 Highway 138 Sw Apt 902 Riverdale GA 30274-4064 |
| Practice Telephone | 6785494263 |
| Mailing Telephone | 6785494263 |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2020-06-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | MFT001741 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295209302 | Amanda Nicholson | Counselor | 6103 Mount Tacoma Dr Sw, Lakewood, WA 98499-2727 | 2019-01-11 |
| Street Address |
269 HIGHWAY 138 SW APT 902 |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30274-4064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862507 | Todd L. Reed | Chiropractor | 83 Upper Riverdale Rd, Riverdale, GA 30274 | 2020-02-05 |
| 1487135992 | Freddie L Sallette IIi | Technician, Pathology | 385 Brookview Dr, Riverdale, GA 30274 | 2018-08-22 |
| 1366933210 | Dawn A. Paul | Nurse Practitioner | 238 Professional Ct Ste A, Riverdale, GA 30274 | 2018-05-27 |
| 1851894588 | Absolute Health Family & Urgent Care Clinic | Clinic/Center | 7574 Ga 85, Riverdale, GA 30274 | 2018-03-08 |
| 1366972127 | Jamillah Ingram | Physical Therapy Assistant | 315 Upper Riverdale Rd., Riverdale, GA 30274 | 2017-06-14 |
| 1114456514 | Grace L Kelson | Licensed Practical Nurse | 9142 Clubhouse Dr, Riverdale, GA 30274 | 2017-06-08 |
| 1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
| 1265857692 | Right Choice Enterprises LLC | Technician | 638 Sterling Ct, Riverdale, GA 30274 | 2014-02-21 |
| 1942571625 | Lowes Guardian Angel LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7056 Eunice Dr., Riverdale, GA 30274 | 2012-01-26 |
| 1508134156 | Education System Management, Inc | Social Worker | 125 Highway 138, Riverdale, GA 30274 | 2011-12-12 |
| Find all providers in zip 30274 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669726741 | Angie Berry | Marriage & Family Therapist | 5149 S 1500 W, Riverdale, UT 84405-3926 | 2012-10-29 |
| 1487933909 | Taylor Cameron Herrin | Marriage & Family Therapist | 5149 S 1500 W, Riverdale, UT 84405-3926 | 2011-08-15 |
| 1710068473 | Blake Thomas Halliday | Marriage & Family Therapist | 5149 S 1500 W, Riverdale, UT 84405-3926 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548869183 | Michael Tanner | Marriage & Family Therapist | 5763 Village Loop, Fairburn, GA 30213-4641 | 2020-10-24 |
| 1316546401 | Joseph Keith Brewton | Marriage & Family Therapist | 210 Creekstone Rdg, Woodstock, GA 30188-3732 | 2020-10-20 |
| 1063010528 | Karla Schlumbrecht | Marriage & Family Therapist | 3569 Sumner Rd, Moultrie, GA 31768-0117 | 2020-10-15 |
| 1376140426 | Moandra Johnson | Marriage & Family Therapist | 2037 Weems Rd Apt 6201, Tucker, GA 30084-5263 | 2020-10-01 |
| 1649887431 | Kristi Brynt Godwin | Marriage & Family Therapist | 4457 Kenilworth Cir, Valdosta, GA 31605-8018 | 2020-09-25 |
| 1073129896 | Lotus Nest Counseling Services LLC | Marriage & Family Therapist | 906 Weathers Dr, Montezuma, GA 31063-1016 | 2020-09-17 |
| 1982217378 | Amy Wagner, LLC | Marriage & Family Therapist | 346 Kramer St, Carrollton, GA 30117-3708 | 2020-08-26 |
| 1114539491 | Sil-miracle Walker | Marriage & Family Therapist | 4210 Columbia Rd Ste 7b, Martinez, GA 30907-0439 | 2020-08-19 |
| 1285242099 | Lyons Center, LLC | Marriage & Family Therapist | 110 Kellwood Dr Ste 200a, Perry, GA 31069-3263 | 2020-07-17 |
| 1073131827 | Ilisten, LLC | Marriage & Family Therapist | 106 Danbury Ct, Pooler, GA 31322-9780 | 2020-07-08 |
| Find all providers with the same taxonomy | ||||
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| 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.