Provider Demographics
NPI:1437498367
Name:LOWERY, NICKIA SHAWNELL (MHS LPC, NCC)
Entity Type:Individual
Prefix:
First Name:NICKIA
Middle Name:SHAWNELL
Last Name:LOWERY
Suffix:
Gender:F
Credentials:MHS LPC, NCC
Other - Prefix:
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Mailing Address - Street 1:2255 SATELLITE BLVD
Mailing Address - Street 2:APT J302
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097
Mailing Address - Country:US
Mailing Address - Phone:610-509-5055
Mailing Address - Fax:
Practice Address - Street 1:1840 OLD NORCROSS RD
Practice Address - Street 2:SUITE 300
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044
Practice Address - Country:US
Practice Address - Phone:678-744-7243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
101YP2500X
GALPC009457101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional