Provider Demographics
NPI:1275755712
Name:MEGHAN K NICOLINI PHD PC
Entity Type:Organization
Organization Name:MEGHAN K NICOLINI PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:NICOLINI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-847-9560
Mailing Address - Street 1:1100 JOHNSON FERRY ROAD
Mailing Address - Street 2:BLDG 2 SUITE 1090
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1709
Mailing Address - Country:US
Mailing Address - Phone:404-847-9560
Mailing Address - Fax:404-847-9537
Practice Address - Street 1:1100 JOHNSON FERRY ROAD
Practice Address - Street 2:BLDG 2 SUITE 1090
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1709
Practice Address - Country:US
Practice Address - Phone:404-847-9560
Practice Address - Fax:404-847-9537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2853103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty