NICOLE PEDERSON (NPI# 1275049900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275049900 |
| Entity Type | Individual |
| Full Name | NICOLE PEDERSON |
| Practice Address |
215 Lakewood Way Sw # 205 Atlanta GA 30315-6022 |
| Mailing Address |
445 Markham St Sw Apt D2 Atlanta GA 30313-1405 |
| Practice Telephone | 6783359010 |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2017-12-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538530274 | Nicole Pederson | Behavioral Analyst | 1147 Leigh Ave, Apt 3, San Jose, CA 95126-4533 | 2015-10-07 |
| 1245735364 | Nicole Pederson | Pharmacist | 5885 Barnes Rd, Colorado Springs, CO 80922-3512 | 2018-03-29 |
| 1316485071 | Nicole L Pederson | Genetic Counselor, MS | 400 E Third Street, Duluth, MN 55805-1951 | 2017-02-02 |
| 1487999702 | Nicole Kathryn Pederson | Physical Therapist | 433 Soscol Avenue, Suite B 191, Napa, CA 94559-4040 | 2012-11-28 |
| 1659498475 | Nicole L. Pederson | Physical Therapist | 1700 W Stout St, Rice Lake, WI 54868-5000 | 2007-03-25 |
| Street Address |
215 LAKEWOOD WAY SW # 205 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30315-6022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083181341 | Erin Cole | Specialist/Technologist | Lakewood Ave Se, Atlanta, GA 30315 | 2018-10-25 |
| 1942701081 | Julie Crocker | Dental Hygienist | 1046 Ridge Ave. Sw, Atlanta, GA 30315 | 2018-02-23 |
| 1457695850 | Dominica Aquino Morales-gibson | Physical Therapist | 2850 Springdale Road Sw, Atlanta, GA 30315 | 2012-11-26 |
| 1912264813 | Maxwell Uhakheme | Internal Medicine | 6875 Douglas Blvd, Suite A, Kaiser Permanente Douglasville Medical Center, Douglasville, GA 30315 | 2012-04-16 |
| 1427329093 | Sulonda Smith | Counselor | 34 Atlanta Ave. Se, Hank Aaron Blvd, Atlanta, GA 30315 | 2012-01-13 |
| 1407152507 | Gerald Leroy Griffin | Pharmacist | 520 Boulevard, Atlanta, GA 30315 | 2011-02-07 |
| 1245404854 | Tunisia Finch Cornelius | Dermatology | 1039 Grant St Se Ste A-11, Atlanta, GA 30315 | 2008-04-15 |
| 1356512180 | Chandra Blakely | Counselor | 215 Lakewood Way, Suite 205, Atlanta, GA 30315 | 2008-03-19 |
| 1104043967 | Alvin H. Clair, M.d.p.c. | Dermatology | 777 Cleveland Ave.,sw Ste.500, Atlanta, GA 30315 | 2007-04-20 |
| 1396877742 | Scott M Russell | Speech-Language Pathologist | 1364 Clifton Road, Atlanta, GA 30315 | 2007-03-12 |
| Find all providers in zip 30315 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495411 | Bianca Tiara Abrams | Counselor | 916 Glenwood Park Dr Se, Atlanta, GA 30316-6845 | 2020-10-23 |
| 1780283713 | Stacey Dougan | Counselor | 696 Mountain Dr Ne, Atlanta, GA 30342-3904 | 2020-10-21 |
| 1851998744 | Amanda Hock | Counselor | 3565 Piedmont Rd Ne Ste 510, Atlanta, GA 30305-8202 | 2020-10-05 |
| 1023625985 | Nathlie Dowdell | Counselor | 1939 Sylvan Rd Sw, Atlanta, GA 30310-5019 | 2020-09-24 |
| 1598371304 | Nissa Christina White | Counselor | 3520 Piedmont Rd Ne Ste 300, Atlanta, GA 30305-1512 | 2020-09-17 |
| 1194339689 | Harry Scott Gordon | Counselor | 3342 Rose Rdg, Atlanta, GA 30340-4074 | 2020-09-02 |
| 1023621869 | Naquia Scott | Counselor | 3330 Cumberland Blvd Se # 3330, Atlanta, GA 30339-5995 | 2020-08-30 |
| 1023621653 | Lindsey Hutchins | Counselor | 55 Mcdonough Blvd Se, Atlanta, GA 30315-2316 | 2020-08-24 |
| 1285246009 | Nickesha Melisa Douglas | Counselor | 1976 Flat Shoals Rd Se Ste A, Atlanta, GA 30316-2857 | 2020-08-21 |
| 1407467434 | Life Changes Counseling and Consultant Services, LLC | Counselor | 1003 Virginia Ave Ste 104, Atlanta, GA 30354-1366 | 2020-08-13 |
| Find all providers in ATLANTA | ||||
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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.