Provider Demographics
NPI:1255648952
Name:OLEXICK, NANCY MORRIS (LPC)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:MORRIS
Last Name:OLEXICK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6743 WALNUT COVE RD
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-0483
Mailing Address - Country:US
Mailing Address - Phone:706-781-3951
Mailing Address - Fax:
Practice Address - Street 1:47 WALNUT COVE RD
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-0431
Practice Address - Country:US
Practice Address - Phone:706-781-3951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003730101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GALPC003730OtherLICENSED PROFESSIONAL COUNSELOR