Healthcare Provider Details
I. General information
NPI: 1992051783
Provider Name (Legal Business Name): ERIKA NICHOLE HEINZLE MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/30/2012
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 HUNTINGTON RD STE 802
ATHENS GA
30606-7216
US
IV. Provider business mailing address
145 PENDLETON DR
ATHENS GA
30606-1644
US
V. Phone/Fax
- Phone: 706-395-5266
- Fax: 855-700-4579
- Phone: 706-395-5266
- Fax: 855-700-4579
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | LPC007119 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: