Provider Demographics
NPI:1639295702
Name:ALI, NADIM SULAIMAN (LPC)
Entity type:Individual
Prefix:MR
First Name:NADIM
Middle Name:SULAIMAN
Last Name:ALI
Suffix:
Gender:M
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:P.O. BOX 115403
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-1704
Mailing Address - Country:US
Mailing Address - Phone:678-820-9053
Mailing Address - Fax:404-393-9973
Practice Address - Street 1:1156 EGGLESTON ST SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-1704
Practice Address - Country:US
Practice Address - Phone:678-820-9053
Practice Address - Fax:404-393-9973
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA03775101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA370911651AMedicaid