Provider Demographics
NPI:1801187745
Name:NICOLAS, ERIN GRACE (MS, LPC, CPCS, RPT-S)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:GRACE
Last Name:NICOLAS
Suffix:
Gender:F
Credentials:MS, LPC, CPCS, RPT-S
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:GRACE
Other - Last Name:PRIDGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, CPCS, RPT-S
Mailing Address - Street 1:3111 ARBORWOODS DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5292
Mailing Address - Country:US
Mailing Address - Phone:770-377-2593
Mailing Address - Fax:
Practice Address - Street 1:11675 CENTURY DR UNIT C
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-8367
Practice Address - Country:US
Practice Address - Phone:404-492-6267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006447101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health