Provider Demographics
NPI:1669857249
Name:OGLESBY, NEKIBRA SHANNELL (LPC)
Entity type:Individual
Prefix:
First Name:NEKIBRA
Middle Name:SHANNELL
Last Name:OGLESBY
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 1:1128 AKERS RIDGE DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3259
Mailing Address - Country:US
Mailing Address - Phone:678-315-1554
Mailing Address - Fax:
Practice Address - Street 1:1128 AKERS RIDGE DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3259
Practice Address - Country:US
Practice Address - Phone:678-315-1554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008453101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health