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NPI Code Detail

MEDICARE: MRS. ASHLEY MICHELLE NOLLENBERGER LPC

MEDICARE: MRS. ASHLEY MICHELLE NOLLENBERGER LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLPC010476GA

General Provider Information

NPI Number : 1417430075
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ASHLEY MICHELLE NOLLENBERGER LPC
Provider Business Mailing Address
First Line : 6225 SANTA FE TRL
Second Line :
City : CUMMING
State : GA
Zip : 30028-4916
Country : US
Telephone Number : 470-253-4557
Fax Number :
Provider Business Practice Location Address
First Line : 104 PILGRIM VILLAGE DR STE 300
Second Line :
City : CUMMING
State : GA
Zip : 30040-9232
Country : US
Telephone Number : 470-253-4557
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2018
Last Update Date : 04/14/2026

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